To participate in a Webster & Associates Group Purchasing Program, just complete the following agreement.

*First Name
*Last Name
*Organization
Title
*e-mail
*Phone Number
*Address 1
Address 2
*City
*State   *Zip  
* By checking this box, you are indicating that your organization wants to access the Group Purchasing Program offered by Webster & Associates, Inc. allowing your organization to take advantage of the Program benefits and discounts. This also indicates your acceptance of the terms and conditions of the Program. In addition, you agree to keep all Program information (including prices) confidential.