PROGRESS E-Mail Group			PEG Membership Form
c/o PEG Holdings			Fax: 630-523-5764
840 W. Lake Street  Unit 406		Phone: 630-523-5762
Roselle, IL 60172-2889			FEIN: 36-4230086

Membership is $75 per person / year.

For corporate memberships use http://www.peg.com/corporate.html

If paying for more than one, include the names and e-mail addresses
of each person.


Name   : _____________________________________________________

Company: _____________________________________________________

Address: _____________________________________________________

       : _____________________________________________________

       : _____________________________________________________

City   : ______________________________ State: ______ 

Postal : _____________________ Country: ____________________


E-Mail : _________________________________________________________


Individual Membership: _$75___ 


Note: PEG no longer accepts credit cards except via Paypal.