AAEA Membership Form
There are three sections: About the Organization, About You, and Membership Information. Please fill out as much as you can, noting that there are some required fields. Upon receipt of this form, your organization will receive an invoice to the Billing Email you provide. Please contact Jill Balaster, (jbalaster@arkansasadvancedenergy.com) with any questions.
About the Organization
Organization's Name
*
Organization's Advanced Energy Sector
Please Select
Renewable Energy
Energy Efficiency
Alternative Fuels/Bioenergy
Education/Research
Service Provider*
Indirect (Legal, Accounting, Insurance, Contractor, Engineer, etc.)*
Other*
*Please describe below
*If you selected service provider, other or indirect please describe
Organization's Number of Employees
Organization's Primary Email
example@example.com
Organization Billing Email
*
example@example.com
Organization's Main Number
Please enter a valid phone number.
Organization's Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization's Above Address Is
Physical
Mailing
Both
Other
Organization's Website
*
Please provide a brief description of your company/organization
*
Company Logo
Browse Files
Drag and drop files here
Choose a file
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of
Organization Socials
Organization's Instagram
Organization's Facebook
Organization's LinkedIn
Organization's X (formerly Twitter)
Organization's Newsletter Link
We like to be in the know with your organization so we can highlight you. If you have a newsletter, please provide the link to subscribe.
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Next
About You
Your Name
*
First Name
Last Name
Your Email
*
example@example.com
Your Title
Your Work Number
Please enter a valid phone number.
Your Mobile Number
Please enter a valid phone number.
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Next
Membership Information
Membership Levels
There are varying membership tiers to choose from, from our amazing annual sponsor members who help keep AAEA running, to business tiers based on number of employees, to institution and student memberships. Please indicate which membership tier you would like to join at. Note that only nonprofits, educational institutions, and government entities are considered “Institutional Members.” Custom memberships are available. Memberships renew annually in January; if joining outside of that time, your dues will be prorated.
Membership Level
*
Please Select
Champion • Annual Sponsor Membership • $25,000 Annually
Leader • Annual Sponsor Membership • $10,000 Annually
Innovator • Annual Sponsor Membership • $5,000 Annually
Business Membership (51+ employees) • $3,000 Annually
Business Membership (6-50 employees) • $1,500 Annually
Business Membership (1-5 employees) • $750 Annually
Institutional* Membership • $500 Annually
Student Membership • $50 Annually
Additional Member Update and Newsletter Recipients
In the fields below, please add the name(s) and email(s) of anyone who would like to receive member updates and newsletters.
Additional Name 1
First Name
Last Name
Additional Email 1
example@example.com
Additional Name 2
First Name
Last Name
Additional Email 2
example@example.com
Additional Name 3
First Name
Last Name
Additional Email 3
example@example.com
Additional Name 4
First Name
Last Name
Additional Email 4
example@example.com
Additional Name 5
First Name
Last Name
Additional Email 5
example@example.com
Submit
Should be Empty: