Membership

Corporate Member Information

Primary Contact

Email Address:

First Name:

Last Name:

Company Name:

Company Address

Address 1:

Address 2:

City:

Postal Code:

State:

Country:

Work Phone:

Fax:

TAB Representative Contact

Each OMAC Corporate Member is entitled to a seat on the OMAC Technical Advisory Board, or TAB. The TAB will function in an advisory role to the OMAC Board of Directors, and focus on the "technical" aspects of OMAC operations and its working groups. Each member will be given the opportunity to identify and assign a representative from their respective company/organization to serve on the TAB for the term of one year, or the length of time the company/organization remains a paid corporate member of OMAC.

We choose not to appoint a representative to the "TAB" at this time. We are aware that we may appoint a representative at any point during the course of our paid membership period.

Tab Representative Name:

Address 1:

Address 2:

City:

Postal Code:

State:

Country:

Home Phone:

Fax:

Types of Sponsorship:

Please check the category of membership that applies:

End user/OEM large company member ($3000)
(> $100 million sales/year)
End user/OEM small company member ($1500)
(< $100 million sales/year)
Technology provider large company member ($3000)
(> $100 million sales/year)
Technology provider small company member ($1500)
(< $100 million sales/year)
Non-Profit Institution/Government Agency member ($1000)
Academia member ($500)

Payment:

Credit Card information not required for Interest Community Membership Level or Additional User to Company Membership.

Select Payment Type:

Credit Card Number:

Name on Credit Card:

Expiration Date (MM/YY):
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