Learning CONSORTIUM Membership Application
(all fields required)
Company name:
Primary contact's
first and last name:
Contact's title:
Address: Street:
 
City:
State:
ZIP / Postal code:
Country:
Phone:
Fax:
Email address:
What is the industry or product focus of your organization?
 
What are your primary reasons for joining the Learning CONSORTIUM?
 
How new or advanced is your organization in the use of learning and technology? (We have members at every stage of development!)
 
How did you hear about the CONSORTIUM?
 
   
I understand that I am submitting an application for my organization to join the Masie Learning CONSORTIUM for a 12 month membership at a cost of $5,000.
 
Someone from our staff will contact you regarding this application.
Thank You!