Professional Services Council
The Voice of the Government Services Industry NEW MEMBER APPLICATION—Associate Membership Associate Membership in the Professional Services Council is available to organizations which do not qualify for regular membership (for-profit companies engaged in the business of furnishing professional or technical services to the government) but which provide commercial or investment banking services; venture capital, investment analysis or other investment services; legal services; or other services to the professional and technical services industry. Associate members have no voting privileges and do not qualify for representation on the Board of Directors. Company Information
Please provide your company information as it should appear in PSC’s internal membership database and membership list. Company Name____________________________________________________________________________________ Parent Company___________________________________________________________________________________ Company Address__________________________________________________________________________________ Main Telephone ___________________________________ Main Fax________________________________________ Web Address______________________________________________________________________________________ Year Established______________________ # of Field Offices_____________________ # of Employees_____________ Please attach company description (of 25 words or less).
Key PSC Contacts Principal Contact__________________________________ Title____________________________________________ Address__________________________________________________________________________________________ Telephone________________________________________ FAX____________________________________________ E-mail Address____________________________________________________________________________________ Assistant’s Name, Telephone, and E-mail Address_________________________________________________________ Alternate Contact__________________________________ Title____________________________________________ Address__________________________________________________________________________________________ Telephone________________________________________ FAX____________________________________________ E-mail Address____________________________________________________________________________________ Assistant’s Name, Telephone, and E-mail Address_________________________________________________________ *Primary Contact__________________________________ Title____________________________________________ Address__________________________________________________________________________________________ Telephone________________________________________ FAX____________________________________________ E-mail Address____________________________________________________________________________________ Assistant’s Name, Telephone, and E-mail Address_________________________________________________________ *The Primary Contact is the Individual whom you wish to manage your company’s membership with PSC.
4401 Wilson Boulevard, Suite 1110, Arlington, Virginia 22203
P: 703-875-8059
F: 703-875-8922
www.pscouncil.org
Key Executives* Name
Corporate Title
Phone Number
CEO/President Asst. to President CFO COO General Counsel Head of Contracts Head of HR Head of Govt. Relations Head of PR/Communications Head of Business Development *For PSC internal classification use. Please list actual corporate titles in the space provided.
Dues Structure for Associate Members
Other Professional Services Firms Financial Institutions (Dues for financial institutions are based on the institution’s assets as outlined below.)
Law Firms (Dues for law firms are based on the firm’s number of lawyers as outlined below.)
Select one: Assets
Select one: Assets
Amount of Dues
m < $750 million in assets
$2,900
m $750 million to $10 billion in assets
$4,500
m > $10 billion in assets
$5,800
Amount of Dues
m 1–40 lawyers
$2,900
m 41–99 lawyers
$4,500
m 100 or more lawyers
$5,800
m Other professional services firms pay annual membership dues in the amount of $5,800.
Acceptance Dues cover one year of membership in PSC. The date your original application is received is your renewal date for subsequent years. New member applications are subject to the approval of the PSC Board of Directors. Amount of Dues Enclosed $_________________________ Affairs of PSC are conducted in accordance with our Charter, Bylaws, and Code of Professional Conduct. I hereby acknowledge that I am aware of PSC’s Code of Conduct and agree to adhere to its terms. Payment information Credit card number _________________________________________________________________ Expiration date ____________________ Security code ____________________________________ Signature_________________________________________ Title_______________________________ Date__________ PSC dues are: • 96% allowable for inclusion in the indirect rates of government contractors and • 89% may be deductible for federal income tax purposes. (According to IRS regulations, the portion of dues allocable to lobbying activity is not tax deductible. PSC estimates that 11% of your dues is allocable to lobbying activities and, therefore, not deductible.) Dues paid to PSC are not deductible as charitable contributions. Please consult your tax advisor for individual assistance for January 2013 your specific situation.