Level of Membership * Premier Membership $1000Basic Membership $365
Referred to WITA by? *
Company Name *
Zip Code *
Description of Companies Services (25 Words or Less) *
Company Representatives For Online Member Directory:
List all company representative who you would like listed in the online WITA Member Directory.
Email and Newsletter Distribution List—Person to receive emails about upcoming events and newsletters
Accounting Contact – Person to receive membership dues invoices
The Washington Independent Telecommunications Scholarship Association (WITSA) was formed in 1986 for the purpose of awarding higher education scholarships to the dependent children of full-time employees of Washington Independent Telecommunications Association Member companies and Associate Member companies located in Washington. Awards are made anonymously and are based on academic achievement, curricular and extra-curricular activities.
If you would like to make a cash donation to WITSA to help fund a scholarship award, please enter amount here (and add to your payment):
6 + 0 = ? Please prove that you are human by solving the equation *
You can print this form and Email it OR print the form and mail to:
PO Box 2473
Olympia, WA 98507
Join us and let your voice be heard. We are Washington’s
Telecom Advocate on things that matter to you and your business.
PO Box 2473
Olympia, WA 98507-2473