MIDDLE TENNESSEE FEDERAL EXECUTIVE ASSOCIATION

APPLICATION FOR MEMBERSHIP

Check One:           ____Current Member

     _____ New Member

Name: ____________________________________

Name of Agency: __________________________

Position/Title: __________________________

Business Phone: __________________________

E-mail Address:______________________________

Agency Address: ____________________________

City:  ____________________________________

State: _______________ Zip Code: __________

Please return this form and a fee of $20.00 to:

 Melissa Cothron

Internal Revenue Service

801 Broadway, MDP 51

Nashville, TN  37203

Webmaster and Point of Contact for this web site:

Melissa Cothron
Internal Revenue Service
801 Broadway MDP 51
Nashville, TN  37203

Phone: (615) 250-5323

E-mail: Melissa Cothron