Pilot Program Application

Fee: $1000 per year

Company/Firm:

Address:

City: State: Zip:

Telephone: Fax:

Name and Job Title:

Email: AAEI Committee of Interest (choose one):

Chemicals International Policy

Customs Regulated Industries
Drawback Textiles
Export Trade Policy
Healthcare Industries Western Regional

Type of Card: (check one) □ Visa □Master Card □ American Express

Card Number: __________________________________

Expiration Date:_____________ Name (as it appears on card): _________________

Billing Address:

Billing Zip Code: CVV/Security:

Industry:

Type of Business/Profession: ________________________________________________________

Referred By (AAEI Member): __________________________________________________

Complete this form and forward with credit card information or check payable to:
AAEI, 1717 K Street, NW, Suite 1120; Washington, DC 20006
Telephone 202.857.8009 • Fax 202.857.7843 • Email HQ@aaei.org