2012 On My Own Time Business Registration Form Registration fees are based upon whether the company is a BCA member and the number of employees in participating offices. Please contact us if you have any questions. CompanySenior ExecutiveTitleMailing AddressStreet AddressAddress Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificStateZip CodeThe liaison from our business (called the Company Coordinator) who will work with Business Council for the Arts will be:NameFirstLastTitleMailing AddressStreet AddressAddress Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces PacificStateZip CodePhoneFaxEmail*******************************************************************************************************************Registration Fees (based on the number of employees in participating offices):BCA Membersup to 99 employees100-399 employees400-999 employees1000+ employeesFees $250 $450 $700 $1,450 Non-BCA Membersup to 99 employees100-399 employees400-999 employees1000+ employeesFees $350 $600 $1,500 $2,500 Sign up online and be invoiced for the Registration FeePrint and mail with the Registration FeeReturn to: Business Council for the Arts 8687 North Central Expressway, Suite 2131 Dallas, TX 75225 972.991.8300 office | 972.991.8320 fax | bca@ntbca.org On My Own Time is a trademarked program of Business Council for the Arts.
