MEMBERSHIP APPLICATION
To apply for membership, please complete all questions.
Organization Name
*
As you would like it to appear on membership roster.
Organization Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Organization Website
*
Years in Business
*
Number of Employees
*
Industries Served (Check all that Apply)
*
Aerospace
Space
Defense
Medical/Biotech
Energy
Precision Industrial Equipment
Other
Brief Description of your Organization's Products and/or Services
*
This will be used in your membership profile.
Organization Logo
Browse Files
Drag and drop files here
Choose a file
This will be used in your membership profile.
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Primary Contact Name
*
First Name
Last Name
Primary Contact Email
*
example@example.com
Primary Contact Work
*
Please enter a valid phone number.
Primary Contact Cell
Please enter a valid phone number.
HR Contact Name (if different than above)
First Name
Last Name
HR Contact Email
example@example.com
HR Contact Phone Number
Please enter a valid phone number.
Billing Address
Use the address above.
I want to specify a different billing address.
Billing Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Membership Type (Annual Dues)
*
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( X )
Enterprise
>200 Employees
$
2,500
Large
101-200 Employees
$
1,500
Medium
51-100 Employees
$
1,000
Small
21-50 Employees
$
750
Micro
1-20 Employees
$
500
Affiliate
Education, EDC, Government, Peer Association Organizations
$
250
Date of Application
*
.
Month
.
Day
Year
Date
Submit
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