Join today by mailing this Application to:
Members Fee (First Year) Discounted to $ 100.00 ($ 125 Off)
North American Association Network at Merrell Institute
1461-16 Lakeland Ave., Bohemia, NY 11716 631~563~7720
Name________________________________________________________
Firm_________________________________________________________
Phone________________________________________________________
Fax__________________________________________________________
E-Mail_______________________________________________________
Web Site_____________________________________________________
Address______________________________________________________
Town________________________________________________________
State_________________________ Zip Code________________________
Specialty______________________________________________________
License Held__________________________________________________
State License Held in_______________________ Expire_______________
Which Directories do you wish to enroll in?
1.___________________________________________________________
2.___________________________________________________________
3.___________________________________________________________
4.___________________________________________________________
Directory Listing will be created using the information created from the above data.
I wish to enroll in the North American Association Network Membership at the discounted
rate of $ 100.00. Renewals will be capped at $ 75.00 Annually.
Signed_______________________________________________ dated__________
To accept this discount offer, you must mail this application to us signed and dated.
Annual fee is normally $ 175.00. Annual Renewals are capped at $75.00 annually.
Much Luck and Success!
Bill C. Merrell, Ph.D.- on behalf of Merrell Institute
Our way of helping you increase your bottom line for the future