MIDI Email Marketing -

MMA Membership/SysEx ID Application

Company Name*

Designated Rep*

First Name*

Last Name*

Email*

Address*

City*

State/Country*

Zip

Phone*

Billing Email/Number

Technical Contact (if different than Designated Rep)

Technical Email

Marketing Contact (if different than Designated Rep)

Marketing Email

Website URL*

Application Date*

Select Your SysEx Region

A=Asia

E=Europe

J=Japan

N=North America

O=Other

Payment Method (select the method you'll use to pay for your MMA membership)*

Check

Paypal

ACH

Wire Transfer

Stripe

Stripe recurring

Wire Transfar

As an authorized representative of the Applicant (above) I hereby request that we be assigned a MIDI System Exclusive ID number.

We agree to pay the then-current fee in each calendar year during which we manufacture any products that use our Manufacturer ID. We understand that our ID will be revoked for failure to pay the annual fee. MMA Membership dues include the cost of the annual SysEx fee.