I know CTIA plays an important role in representing the wireless industry in the political arena. I understand that federal law requires CTIA PAC to obtain written permission in order to share information and solicit contributions from member companies' executive and management personnel.

I also understand that signing this form does not obligate me or anyone else to make a contribution. A member company can authorize only one trade association per calendar year to solicit its employees.

Please enter your CTIA PAC code below. If you need a code, please contact Joe Joiner at jjoiner@ctia.org.

I certify that I am a:

Permission to Solicit

On behalf of my company, I authorize CTIA PAC to solicit personal and voluntary contributions.

Authorized Signature

To sign, type your full name
Email Address
Title of Authorized Signer
Company Name
Company Contact Name (if different from above)
Contact Phone
Contact Email
Note: Under federal law, only U.S. Citizens and Lawful Permanent Residents (i.e., green card holders) should complete this form. If you need further information please contact Joe Joiner: jjoiner@ctia.org or (202) 736-3652.