Clone of Annual Membership Registration Form

2026 OBA Annual Membership Registration Form

Complete the form below to sign up for our association membership.
Welcome to the Oregon Broadband Association!

We’re excited about your interest in joining the Oregon Broadband Association (OBA). To get started, please complete this form to confirm your membership interest and provide the information we need to include your organization in our member directory and communications.

Please note that dues for Broadband Service Provider members (telecommunications companies, internet service providers, and similar organizations) vary based on membership criteria. If this applies to your organization, we will contact you directly to review and confirm your dues amount and may request a few additional details.

Your participation helps strengthen OBA’s mission to advance broadband connectivity, collaboration, and advocacy across Oregon. We are grateful for your interest and look forward to welcoming you, or welcoming you back, to our community.

If you have any questions or need assistance at any point, please don’t hesitate to reach out.

Warm regards,
Mandy Jundt
Name of Person Submitting this Form

First NameLast Name
Your Title or Position
Email
example@example.com
Company Information
Company Name
Company Website
This will be published in the directory.
Company Phone Number
Format: (000) 000-0000.
Company Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please enter a short, but detailed product or service description for your company.
This will be published in the directory.
Please enter the geographic area your company serves.
This will be published in the directory. Examples: Oregon, Washington, PNW, Nationwide, Global, etc.
Are you interested in placing an advertisement in the directory? Premier Associate members receive a 50% discount on advertising opportunities in the directory, newsletter, promotional emails or the website.
Membership Level
Please Select Your Membership Level (Please see the upgraded premier benefits offered below)
Directory Information
Would you like to include your color logo next to your company name in the directory? Make sure you upload your logo at the end of this form, if so. Logos are included for Premier Associate members.
Name of Representative 1 for Directory
This will be published in the directory.
Title of Representative 1 for Directory
This will be published in the directory.
Email of Representative 1 for Directory
example@example.com
Phone Number for Representative 1 for Directory
Please enter a valid phone number.Format: (000) 000-0000.
Would you like to add additional representatives or contacts in the directory?
Name of 2nd Representative for Directory
This will be published in the directory.
Title of 2nd Representative for Directory
This will be published in the directory.
Email of 2nd Representative for Directory
example@example.com
Phone Number for 2nd Representative for Directory
Please enter a valid phone number.Format: (000) 000-0000.
Name of 3rd Representative for Directory
This will be published in the directory.
Title of 3rd Representative for Directory
This will be published in the directory.
Email of 3rd Representative for Directory
example@example.com
Phone Number for 3rd Representative for Directory
Please enter a valid phone number.Format: (000) 000-0000.
Name of 4th Representative for Directory
This will be published in the directory.
Title of 4th Representative for Directory
This will be published in the directory.
Email of 4th Representative for Directory
example@example.com
Phone Number for 4th Representative for Directory
Please enter a valid phone number.Format: (000) 000-0000.
Name of 5th Representative for Directory
This will be published in the directory.
Title of 5th Representative for Directory
This will be published in the directory.
Email of 5th Representative for Directory
example@example.com
Phone Number for 5th Representative for Directory
Please enter a valid phone number.Format: (000) 000-0000.
Communication

In addition to the representatives listed above, please let us know who else should receive our news and updates.
Does your company have a dedicated Event Coordinator that you'd like to receive OBA communications? This is not published automatically in the directory and is used for internal purposes.
Event Coordinator Name

First NameLast Name
Email of Event Coordinator to Receive OBA Communications
example@example.com
Does your company have a dedicated Marketing Contact that you'd like to receive OBA communications? This is not published automatically in the directory and is used for internal purposes.
Marketing Contact Name

First NameLast Name
Email of Marketing Contact to Receive OBA Communications
example@example.com
Payment & Processing

As a small not-for-profit with only two FTEs, we utilize Quickbooks Online for our accounting services and therefore we manually process accounts receivables and sometimes do this in batches once or twice a week. Due to this, there may be a number of days in between your submission and receiving your invoice for payment. We appreciate your patience as we work to process each submission! If you have questions or aren't certain your form was submitted, simply reach out to me and I am happy to help!
How would you like to pay for your membership?
What is the best email to send your invoice to; in case you have a dedicated company AP email? Otherwise, enter your email, if you pay your own invoices.
example@example.com
Please upload a high resolution logo for your company to use in the directory and for signage.

PNG, JPEG formats preferred.
Cancelof
Have any questions or comments? Please email me at mjundt@oba-telecom.org!
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2026 OBA Annual Membership Registration Form

Company Information

Membership Level

Directory Information

Communication

Payment & Processing