163127 09/03/2008 CITY OF CARMEL, INDIANA VENDOR: 361744 Page 1 of 1
ONE CIVIC SQUARE A S T D
s? CARMEL, INDIANA 46032 BOX 1567 CHECK AMOUNT: $199.00
MERRIFIELD VA 22116 -1567 CHECK NUMBER: 163127
CHECK DATE: 9/3/2008
DEPARTMENT ACCOUNT PO NUMBER INVOICE NUM AMOUNT DE
1201 4355300 199.00 ORGANIZATION MEMBER
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AS;T�Di.��M:EM:��Br;.E::RS:H..I::P: APPLI: ATION
Member Information
Please.indlcate if'thls Is a: Membership
Me For.Renewal /Add -on
Rlew A5TD Membership Membership Renewal t U Subscription Add -Qn
Olt'EaLAS fl: :CAMP��Lt
.Name t E -rn ail (For delivery of online benefits, ASTD :foes not renter sell email addresses)'
Et�PI.O. lli4 FAT TRAdrf lt.3 QDOZDWM
s• Title :Phone
.1
Company :Phone 2
0►1E Cl�ll S QIfP�..E
Mailing Address 1 Fax
Mailing Address 2 Chapter Code, Partner Code. or Glottal Network
City State Postal Code
y
1. CALCULATE YOUR' DUES
ASTD Membership Pukes, „include shippir and hard! cq)
Includes Ttp magazine; iull acce la asCa org, accPSS to ASTD xes ar n tools, the Ann 1l S1616 of the Irrdt;stry Feprri, A5TD.
.Links, excl(Aivr6 member discounts, and much more. us Canada /Mexico' All.Other Count/ es
,Total
I ;WBnt t0 enr011Or renew as a: NEW Renewal NEW Renewal NEW Renewal':
�j I Year lvlemher $199 $180 $224 $205 $269 $250 �el
J 1 YearE Member;(international only) N/A N/A $169* $150* $169* $150'
U 2 Year Member $358 $320 $408 $370 :$498 :$460 r
QlSenior .ember (ever62) $90 $90 $115 $115 $160 $160
J Student Mernt er 2 crc:dif flours per year): $59 $59 $59 $59 $59* $59*
*e membership (online benefits only)
Seel Subtotal
2, ADD SPECIALIZED CONTENT (Prices include shippin and handlin
Get specialized content ta: meet your career development
Outside
needs with these subscription products.
U5, U.S. Totaf
ASTD; Book Plus Six pre- selected;ASTD books' per year (over $200 value!) $99 /yr $169/yr
s lniofine Plus Monthly, 16 page; how-to publication (over $129:vaiue.I $99 /yr $159/.yr
J HRDQ Discounted one -year subscription to HRDQ (over $100 value!) $75 /yr $99 /yr
OD /Leadership News,(10 online issues' archives)' $;100 /yr $100 /yr
i E �earning News (:10 ohllne issues 4 archives) $100 /yr '$100 /yc
:J Consulting, News (4 online Issues +.archives) $40 /yr $4l
J Measurement, Evaluation, and ROl News (6 online issues archives) $60 /yr $60 /yr
(Sec, 2)':Subtotal
Total (Add Sec. 1 and 2)
BILLING ADDRESS PAYMENT INFORMATION
(If different from shipping address)
)Q Check drawn on a U.S. Bank and payable.to ASTD' -is enclosed.
I]; Please charge the total.to.my:
Company
❑.VISA MasterCard rJ American Express U Discover"
Address Card
:'.Address
Exp. Date
-city' State:. Postal Code
`Country Signature Date
_`SENDING "Y0lJR PAYMENT
v Mail: ASTD; Box 1567, Merrifield VA, USA 22116 -1567 Phone: 1.800.628.2783 (U.S.) or 1303-683-81 00- Fax: 1.703.299,8723-
Wire Transfer /ACH:'Please contact ASTD Member Services for information. TRANSACTION MUST include name and indicate
"A5 TD Membership. Please provide a copy of the bank's transaction receipt when submitting this form. Purchase'Order: Signed P.O ,'printed on
company letterhead;',must accompany this'application Dues and subscription prices are subject to change,
01 E r1 3 !aa rc J 3
STD
Presc:iCOd by g.�o Board of Accounts ACCOUNTS PAYABLE VOUCHER City Form No. 201 (Rev. 1995)
CITY OF CARMEL
An invoice or bill to be properly itemized must show: kind of service, where performed, dates service rendered, by
whom, rates per day, number of hours, rate per hour, number of units, price per unit, etc.
Payee
ASTD Purchase Order No.
Terms
Date Due
Invoice Invoice Description Amount
Date Number (or note attached invoice(s) or bill(s))
Ofell %A ership Dues for Do
Cam pbell 9.00
Total
I hereby certify that the attached invoice(s), or bill(s), is (are) true and correct and I have audited same in accordance
with IC 5- 11- 10 -1.6.
20
Clerk- Treasurer
VOUCHER NO. WARRANT NO.
08/29/08
ALLOWED 20
�ASTD
IN SUM OF
box 1 567
Merrifield, VA 22116 -1567
$199.00
ON ACCOUNT OF APPROPRIATION FOR
GENERAL FUND
1201 Human Resources
Board Members
DEPT INVOICE NO. ACCT #/TITLE AMOUNT I hereby certify that the attached invoice(s), or
bill(s) is (are) true and correct and that the
553 $1199 00 materials or services itemized thereon for
which charge is made were ordered and
received except
20
�Signa e
Title
Cost distribution ledger classification if
claim paid motor vehicle highway fund