Section  III:  -  Association Dues
To assess you company's association dues, please use your most completed fiscal year to complete the following dues schedule.  All information provided to TRSA is kept strictly confidential.

Step 1: Calculate Revenue Complete the following form to determine the amount of annual revenue used to determine your dues calculation.
1a. 100% Linen Supply and Industrial Revenue	$
1b. 50% Commercial Laundry Service Revenue (COG/NOG)	$
1c. Total Revenue for Dues Calculation	$

Step 2: Determine Dues Base and Revenue Adjustment Factor
Use the chart below to determine your company's Dues Base and Revenue Adjustment Factor by cross referencing your Total Revenue for Dues Calculation from Line 1c.

Revenue Range (Line 1c)	Dues Base	Revenue Adjustment Factor	Maximum Dues
$0 - $499,000	$870	None	$870
$500,000 - $799,999	$1,107	None	$1,107
$800,000 - $1,499,999	$1,818	None	$1,818
$1,500,000 - $6,999,999	$1,890	0.00071	$7,260
$7,000,000 - $14,999,999	$7,367	0.0004374	$12,163
$15,000,000 - $49,999,999	$12,282	0.0003282	$21,113
$50,000,000 - $74,999,999	$21,217	0.0001875	$25,683
$75,000,000 - $174,999,999	$25,684	0.0000662	$32,371
$175,000,000 and More	$32,445	0.00004452	$49,440

2a. Enter the Dues Base for Your Revenue Range	$
2b. Enter the Revenue Adjustment Factor for Your Revenue Range
2c. Enter the Maximum Dues for Your Revenue Range	$
Step 3: Determine Dues Amount Below you will calculate your TRSA dues by adding your Dues Base to the total of your Revenue multiplied by the Revenue Adjustment Factor. However, dues may not exceed the Maximum Dues amount for each category.
3a. Enter Total Revenue for Dues Calculation (Line 1c)	$
3b. Enter Revenue Adjustment Factor (Line 2b)	$
3c. Multiply Line 3a and 3b	$
3d. Enter Dues Base for Your Revenue Range (Line 2a)	$
3e. Add Line 3c and 3d	$
3f. Enter Lower of 3e or 2c	$
Step 4: Discounts Members may take a discount for early payment or automated credit card payments. Please check the discount you wish to claim. For early payment discounts, payment must be received in the TRSA offices by Dec. 31, 2006; and for automatic credit card payments, a credit card number with expiration date and authorized signature must accompany this form.
4% Discount for full payment of 2008 Dues by check before Dec. 31, 2007 2% Discount for full payment of 2008 Dues by credit card before Dec. 31, 2007 1% Discount for automatic credit card payments
Step 5: Payment Indicate your 2008 TRSA Dues and method of payment below.
Please bill my dues:  (Please check one)

Annually	Quarterly		Semi-Annually
(Please check one)
Automatic Credit Card Payment Plan*		One-Time Credit Card Payment
Credit Card: (Please check one)
Visa	MasterCard		American Express

Card Number:
Expiration Date:
Name on Card:
* By agreeing to this option, TRSA will charge your quarterly payments on March 31, June 30 and Sept. 30 or your semi-annual payment on June 30.

2008 TRSA Dues (Line 3f minus Discount)	$
Payment Enclosed or to Be Charged	$

TRSA dues are not deductible as a charitable contribution for federal income tax purposes.  However that may be deductible as a business expense subject to restrictions imposed as a result of association lobbying activities.

Section IV: Special First-Year Member Benefits
Each new member company is eligible for special first-year benefits. Please check the items you would like sent immediately:

	One FREE 2007/2008 Roster/Buyers' Guide
	One FREE TRSA seminar registration, valid for one year form application date (not valid for MMI or PMI)
	One FREE TRSA publication*. Publication #
	Receive 10% off any other publications orders during 2008
	One FREE TRSA videotape; with 49 training videotapes offered in our catalog. Publication #
	Order additional videotapes for just $20 during 2008!
Note: When registering for a free seminar or ordering a free or discounted publication, simply write "Free" or "10% Discount" on the form. * Excludes Washroom Test Kit, Chemicals, CD-ROMs and ProfitPoint™

Section V: Textile Rental Magazine
As a textile rental member of TRSA, your company is entitled to one free subscription for every $120 in paid dues to the association's award-winning magazine, Textile Rental. Please indicate below the names of other individuals from your company (in addition to those noted in Section II) that you would like to receive the magazine.

	Full Name	Formal Title	Mailing Address
1.
2.
3.
4.

Section VI: Digital Library Subscriptions
TRSA's Digital Subscription Library contains more than 130 publications, videos and computer media. The Library contains industry-specific resources on accounting, dust control, healthcare, production, sales and service and strategic management. Access to the Digital Subscription Library is available to members at no additional cost. Contact TRSA at 703/519-0029 for a passcode.

Section VII: TRSAPAC - TRSA's Political Action Committee

Company Name:
Name:
Title:
Company Address:
Company City:
Company State:
Company Zip:
E-mail Address:

		TRSAPAC is authorized to solicit voluntary contributions from myself only as a member of the executive and administrative personnel of my company for the following years.
	OR-
		TRSAPAC is authorized to solicit voluntary contributions from the executive and administrative personnel and stockholders of my company for the following years.

I understand that my company may not approve a solicitation by any other trade association for these years. (Federal law requires political committees to report the name, company, address, occupation and name of employer for each individual whose contributions aggregate in excess of $200 in a calendar year.)

My company is a:

sole proprietorship

partnership

corporation

1. If your company is a sole proprietorship or a partnership, you need not sign the bottom portion of this prior approval form.

2. If you are the principal contact of a corporation, federal law requires you to sign the bottom portion of this prior approval form in order for the executive or administrative personnel of your corporation to be solicited. Based on the box marked above, this will give TRSAPAC permission to solicit voluntary contributions.

Please check below on each year that permission is granted to solicit and bill, based on the box marked above.

2008	2009	2010
2011	2012	2013

Section VIII: Committees
TRSA committees provide program and policy direction for the association. We encourage you or a representative from your company to participate on one of our committees.Your participation not only provides leadership for the association but also gives your company an opportunity to increase its industry visibility and build new relationships.

Would key company personnel be interested in serving on a TRSA committee?
Yes No Maybe - Tell me more.

Section IX: Referrals
If you were referred to TRSA by another member please let us know their name and company name.

Contact Name:

Company Name:

I swear and affirm that I have verified the information, including revenue and dues declarations, on this form is correct. (This box must be checked to complete this form)

Section IX: How to reach us
Please click on Apply to send this application electronically, or print then mail or fax this application with your dues payment to:

Textile Rental Services Association of America (TRSA)
1800 Diagonal Road, Suite 200, Alexandria, Virginia, 22314-2840

If you have any questions about the association or this application please contact us at:
Telephone: (703) 519-0029 • Toll Free: 877-770-9274 • Facsimile: (703) 519-0026