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2023 TETA TLN and ILN Promotional/Advertising Package Application
Tennessee Educational Technology Association
Application for VLN and ILN Partnership Promotional/Advertising Package
January 1, 2023- December 31, 2023
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Membership Contact Information
This is your contact information. Billing contact information is listed below. If this information is the same, please check the box below.
Company Name
*
Your answer
Company Website
*
Your answer
Does Your Company have a E-Rate SPIN number?
*
Please input SPIN number below. If you are a non E-rate vendor, please respond with (N/A).
Your answer
Address
*
Your answer
City
*
Your answer
State
*
Your answer
ZIP
*
Your answer
Phone
*
(xxx) xxx-xxxx
Your answer
FAX
*
(xxx) xxx-xxxx
Your answer
Representative 1
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Email 1
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Representative 2
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Email 2
Your answer
Representative 3
Your answer
Email 3
Your answer
Representative 4
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Email 4
Your answer
Representative 5
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Email 5
Your answer
Representative 6
Your answer
Email 6
Your answer
Type of Partnership Package you are purchasing:
*
VLN (Virtual Learning Network) Partner Package - $5,000
ILN (Instructional Learning Network) Partnership Package - $5,000
Required
Billing Info
If billing information is the same as contact information for Representative #1 above, please check the box and do not fill out the rest of this form.
SAME as Representative #1 above
Bill To:
ie: Account Payable
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Company
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Address1
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City1
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State1
Your answer
ZIP1
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Phone of billing contact
(xxx) xxx-xxxx
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FAX1
(xxx) xxx-xxxx
Your answer
Email of billing contact
*
Your answer
Please mark method of payment
Invoice will be sent to the Accounts Payable person listed above. A 3% surcharge will be added for credit card use.
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