BECon Electronic Communication Authorization

Electronic Communication Authorization

If you are a member of BECon and would like to change from fax to email communication, or add additional Alternate Contacts, please complete this form. Note: BECon uses the program Qurb to control spam. Messages from addresses that Qurb doesn't recognize are quarantined until the address of the sender can be confirmed. If you receive an email from BECon with [Qurb #------] in the subject line you need only "Reply" and "Send" without making any changes, especially to the subject line, for your original email to be moved to BECon's Inbox.

Member Name (Company/Group/Association):

Name of Primary Contact, (Required):
Primary Contact's Email Address, (Required):

1st Alternate Contact:
1st Alternate's Email Address:

2nd Alternate Contact:
2nd Alternate's Email Address:

Billing Contact:
Billing Contact's Email Address:
Should Billing Contact receive all communications?	Yes No

Upon sending this form all communications such as member information and newsletters will be sent to the Primary Contact and the Alternate Contact(s) (if any) via email. This information will only be emailed to the Billing Contact if authorized by responding "Yes" to the question above. All invoices will be emailed to the Billing Contact, or if this field is left blank, to the Primary Contact.