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312 East Capitol
P.O. Box 785
Jefferson City, MO
65102

Ph: 573.634.2527
Fx: 573.634.5792

ric@mtia.org
rosie@mtia.org
lisa@mtia.org

Please fill in the electronic form below to submit your update for the next Member Directory printing. This information comes directly to MTIA and is strictly for directory listing purposes. Or, feel free to access the printable version of this form (in Adobe Acrobat), fill in, and send via USPS to the address at left.

Note: Additonal company personnel submitted will be listed in the MTIA Directory and/or receive meeting/activity notices. List in the order to be printed in the directory.

Primary Contact Information:

Company Name:

Contact:

Title:

Address:

City:

State:

Zip:

Phone:

Fax:

Email:

Web Site:

Directory Listing Mailing List Both Lists Main Contact for Billing Purposes

Description of Services or Products (25 Words or Less):

Secondary Company Personnel (No. 1):

Name:

Title:

Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

Directory Listing Mailing List Both Lists Main Contact for Billing Purposes

Secondary Company Personnel (No. 2):

Name:

Title:

Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

Directory Listing Mailing List Both Lists Main Contact for Billing Purposes

Secondary Company Personnel (No. 3):

Name:

Title:

Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

Directory Listing Mailing List Both Lists Main Contact for Billing Purposes

Secondary Company Personnel (No. 4):

Name:

Title:

Address:

City:

State:

Zip:

Phone:

Fax:

E-mail:

Directory Listing Mailing List Both Lists Main Contact for Billing Purposes

Mark the box beside the services your company offers:

	ACD Call Centers		Lightning Protection Grounding Systems
	Accounting		Local Tariff Services
	Acquisition Services		Locating/Testing Equipment
	Advertising		Long Distance Consulting
	Aircore Cable Services		Mailroom Services
	AOCN Services		Management Services
	Architectural Design		Manufacturer/Manufacturers' Rep
	Billing & Collection Services		Marketing & PR
	Broadband Transmission Services		Microwave Systems
	Business & Succession Planning		Multiplexer Equipment
	Cable Inst./Const./Man.		Network Access Equipment
	Cable TV Services		Network Design & Const.
	Caller ID Equipment		Network Management Systems
	Calling Card Systems		Operational Support Systems
	Carrier Access Billing Service		Operator Center Software
	Centrex Systems Products		Opportunity Analysis
	CLEC Services		Outside Plant
	Comm. Equip./Cables/Acc.		Paging Systems/Services
	Computer Hardware		Power Prod./Syst./Equip./Serv.
	Computer Software		Promotional Products
	Conduit & Innerduct		Protection Equip./Serv.
	Connectivity Products		Regulatory Services
	Construction		Repair/Testing
	Consulting Services		Risk Management
	Cost Separations		Safety Equipment
	Custom Programming		Safety Programs & Training
	Database Management Services		Satellite Services
	Database Management Software		Service Bureau
	Database Processing		Signaling System 7 (SS7)
	Directory Publishing		Software Provider
	Distributor		Staffing & Project Services
	Employee Benefits/Consulting		Strategic Planning
	Engineering		Switching Equipment
	Equipment		Synchronous Optical Network
	Estate Planning		Tax Planning
	Fiber Optic Comm. Equip./Serv./Training		Test Equipment
	Financial Services		Traffic Management
	Frame Relay		Training/Education Services
	Information Management Systems		Transmission Capacity
	Insurance Services		Transmission Equipment
	Interconnection Agreements		Underground Facility Protection
	Internet Billing Services		Unified Access Platform
	Internet Development		Vaults/Manholes
	Interstate Access Tariff Administration		Voice Mail Messaging
	ISDN Products		Voice Processing Systems
	Legal Services		Wireless Comm. Equip.
	Wireless Services		XDSL Equipment



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