Industry Council Application

If you are a member registering on behalf of your company, please log in first, and then complete this form.

Company Name*
Website*
Name*
First Last
Name of the primary contact managing the Industry Council membership. This does not have to be one of the memberships.
Title*
Email*
Phone*
Logo
Accepted file types: png, jpg.
Please upload a high-resolution PNG or JPG of your logo. PNG with transparent background is preferred.
Logo (Print)
Accepted file types: svg, pdf.
Please upload the vector version of your logo (in PDF or SVG format). Note: please DO NOT save a JPG or PNG as a PDF. Ask your marketing/graphics person for a vector PDF or SVG.
Logo Trouble?
- I'm having trouble uploading my logo. Please email me.
(Please note, we cannot display your sponsorship on the website until we have a logo file).
Council Member Name*
First Last
Please provide the name of the individual who will represent your organization on the council for 2020.
Council Member Email*
Members Covered Under Organization Membership*
First Name Last Name Email Chapter of Interest
Payment Type*
- Credit
- ACH
- Check
Council Annual Membership*
Price: $5,000.00
Total
$0.00

First Name	Last Name	Email	Chapter of Interest