Membership Application Form

Contact Information

Please do not use all capital letters when completing form.
First Name: *
Middle Name:
Last Name: *
Title: *
(use N/A if in between jobs)
Company: *
(use N/A if in between jobs)
Business Address
Address: *
 
City: *
State: *
Zip: *
Work Phone: *
(Please use dots (.) when entering phone numbers, e.g. 555.555.5555)
Work Fax:
(Please use dots (.) when entering phone numbers, e.g. 555.555.5555)
Work Email: *
Check here if you do not want the above business information to be listed in the online membership directory.
Home Address

In the event you forget to contact WEB when your work address or work email address change, your home address will enable WEB to keep in contact with you. Please fill in your home information below; it will not be part of the online membership directory.

Address:
 
City:
State:
Zip:
Home Phone:
(Please use dots (.) when entering phone numbers, e.g. 555.555.5555)
Home Email:

Professional Information

Fill in as much information as possible about your work to help people find you in the online directory.

Number of Employees in Company: *
Estimated Co. Annual Revenue:
Number of Years in Profession: *
Professional Designation/Certifications: Actuarial
Attorney
CPA
CEBS
SPHR/PHR
Other: (Separate with commas)
Position Within Company: *
If "Other" Please Specify:
Business or Industry: * Insurance Broker/Consultant
Plan Sponsor:
Service Provider:
Government
Other:
Industry Area: * Retirement
Health & Welfare
Flexible Benefits
Other:
Areas of Practice/Responsibility: * Asset Management/Investments
Collectively Bargained Plans
Communications
Compensation
Defined Benefit Plans
Defined Contribution Plans
Executive Compensation
Fiduciary Responsibility
Governmental Plans
Human Resources
International Benefits
Legal Services
Managed Care Provider
Marketing
Mergers & Acquisitions
Operations
Outsourcing
Plan Design - Health Care
Plan Design - Other Insurance
Plan Design Retirement
Plan Funding
Plan Termination
Third Party Administrator - Healthcare
Third Party Administrator - Retirement
Voluntary Insurance Programs
Other:

Join Worldwide Employee Benefits Network Today!

Save with a Corporate Membership: Enroll five members from the same organization and the membership rate is reduced to $170 each. Members do not have to be in the same chapter. This is a savings of $150 over five Individual memberships. A Corporate Membership cannot be processed online.

Email WEB at info@webnetwork.org or call 888-795-6862 to apply for a Corporate Membership.

Questions? Contact WEB at info@webnetwork.org or 888-795-6862.

WEB Membership Rates
Type of Membership
(per person)
Membership Rates
Individual Membership in Your Local WEB Chapter — 1 Year $200
Individual Membership in Your Local WEB Chapter — 2 Years $350: Save $50!
Government Membership in Your Local WEB Chapter $125
Associate Membership in Your Local WEB Chapter*

*Associate memberships apply if you are unemployed, on unpaid leave, retired or a full-time student.
$95
Not near a current WEB chapter?
Become an Individual Online Member of WEB*

*Individual Online Members of WEB enjoy all the regular benefits of WEB Membership, but are not affiliated with any local WEB Chapter. Individual Online Members may attend local Chapter Events, but must pay the non-member rate. Individual Online Members do not have access to local Chapter Presentations online.
$100
Corporate
(for 5 people)

This type of membership cannot be processed online. To expedite quickly, contact WEB at info@webnetwork.org
Great Savings!
$850 for five members ($170 each) from the same organization - even if located in different cities!

WEB Membership Selection

All new WEB memberships, with the exception of the Two-Year Membership, cover a 12-month period.

During a membership campaign, extra months are offered for the same price as a 12-month membership.

Note: WEB dues are usually deductible as a business expense. Check with your tax advisor to determine the tax deduction that may apply to your particular circumstance.

Membership Type: * Individual Membership ($200)
Two-Year Individual Membership ($350) Save $25.00!
Government Membership ($125)
Associate Membership* ($95)
Online Membership — Limited Access ($100)

* Associate level membership is available to retirees, full-time students and benefits professionals who are unemployed or on unpaid leave.

* Individual Online Members of WEB enjoy all the regular benefits of WEB Membership, but are not affiliated with any local WEB Chapter. Individual Online Members may attend local Chapter Events, but must pay the non-member rate. Individual Online Members do not have access to local Chapter Presentations online.

Corporate Membership ($850) A great savings! Five members from one company at $170 each. Multiple locations accepted within the same company.

We cannot activate a corporate membership online. For more information, email info@webnetwork.org or call 1-888-795-6862.

Chapter

If there is no chapter in your community and you would like to form one, please contact WEB.

Select Chapter: *

Payment Information

Click the "Submit Application" button once below to send us your application. You will receive a confirmation email.

If you wish to pay with a credit card, your membership will be activated immediately. To pay with a credit card, click the radio button to the left of one of these images: Amex, MasterCard or Visa.

If you wish to pay by mailing a check, your membership will be activated when payment is received. To choose the option to mail your payment, click the radio button to the left of the image "Check".

Mail your payment within 5 days to our NEW ADDRESS:

   Worldwide Employee Benefits Network
   11520 North Central Expressway, Suite 201
   Dallas TX 75243

TOTAL: $
Payment Method: *  American Express    MasterCard    Visa    Visa
Credit Card Number: *
Expiration Date: * /
Card Holder Name: *

Do not click the button more than once or your credit card may be charged more than once.

   

Bookmark and Share