Become a Member - USMCOC Noreste Chapter

Thank you for your interest in becoming a member! Please complete the following form and submit it along with any required documentation.

Section 1: Business Information

Legal Business Name*

Doing Business As (DBA)

Business Address

Street Address*

City*

State*

Zip Code*

Mailing Address (If different from business address)

Street Address/PO Box

City

State

Zip Code

Website

Phone Number*

Company Email Address*

Business Start Date*

Type of Business*

Industry/NAICS Code*

Number of Employees*

Annual Revenue*

Brief Description of Products/Services Offered*

Section 2: Primary Contact Information

Name*

Title*

Phone Number*

Company Email Address*

Personal Email Address

Section 3: Key Roles Contact Information

HR Contact

Name

Title

Phone Number

Email Address

Personal Email Address

Finance Contact

Name

Title

Phone Number

Email Address

Personal Email Address

Commercial Contact

Name

Title

Phone Number

Email Address

Personal Email Address

Section 4: Membership Category

Please select the appropriate membership category:

Individual Membership ($300 USD)

Corporate - Annual Rev <10M ($500 USD)

Corporate - Annual Rev 10M - 50M ($1000 USD)

Corporate - Annual Rev 50M - 100M ($1500 USD)

Corporate - Annual Rev >100M ($2000 USD)

Regional ($2500 USD)

Bi-National ($10,000 USD)

Associate: Non-Profit, Governmental, NGO's and Educational Organizations ($100 USD)

For more details about the membership categories and benefits visit: Membership Details

Section 5: Agreement and Acknowledgement

I/We hereby certify that the information provided in this application is true and accurate to the best of my/our knowledge.

I/We authorize USMCOC to verify the information provided in this application.

By submitting this application, I/we acknowledge that I/we have read and understand the terms and conditions of membership.

Ready to Become a Member?

Membership Application Form

Section 1: Business Information

Business Address

Mailing Address (If different from business address)

Section 2: Primary Contact Information

Section 3: Key Roles Contact Information

HR Contact

Finance Contact

Commercial Contact

Section 4: Membership Category

Section 5: Agreement and Acknowledgement