Florida Photonics Membership Application Form

Florida Photonics

Membership Application
Company Name
Primary Contact*

TitleFirst NameLast Name
Primary Contact E-mail Address*
Primary Contact Phone Number*

Area CodePhone Number
Alternate Contact*

TitleFirst NameLast Name
Alternate Contact E-mail Address*
example@example.com
Alternate Contact Phone Number*

Area CodePhone Number
Company Address*

Street Address

Street Address Line 2

CityState

Zip Code
Description of Company/Organization
High Resolution Logo*

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Number of Employees
Membership Categories
Active Core Membership:
Any organization or individual that designs, develops, manufactures, or commercializes products (components, systems, software, consulting services, etc.) related to the practical application of photonics technology (as defined in the FPC Bylaws). Voting member.
Affiliate Membership:
Any academic institution or academic professional, trade and industrial organizations, non-profit and governmental organizations with an interest in supporting or collaborating with optics and photonics professionals. Voting member.
Associate Membership - Service Providers:
Any service providers seeking to assist or collaborate with professionals in the optics and photonics industry. Non-voting member.
By submitting this application, you are applying for membership with the Florida Photonics Cluster and will receive an invoice for membership dues. Membership is subject to payment of dues and approval.
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Florida Photonics