MIDI Email Marketing -

MIDI Association Corporate Membership Application

Company Name *

Designated Rep's First Name *

Designated Rep's Last Name *

Designated Rep's Email *

Marketing/Trade Show Email (if different than Designated Rep)

Accounting/Billing Email *

Company Address *

City *

State/Province/Region/Prefecture *

Company Country *

Zip/Postal Code *

Phone

Website URL *

Corporate Member Level and Sponsorships *

$600-Annual Dues (sales under 1 Million $US/yr.)

$1,200-Annual Dues (sales between 1 and 10 Million $US/yr.)

$3,000-Annual Dues (sales between 10 and 100 Million $US/yr.)

$4,000-Annual Dues (sales between 100 Million and 1 Billion $US/yr.)

$8,000-Annual Dues (sales between 1 and 10 Billion $US/yr.)

$12,000-Annual Dues (sales between 10 and 100 Billion $US/yr.)

$20,000-Annual Dues (sales over 100 Billion $US/yr.)

Please verify your request. *

For MIDI Association Corporate members, as an authorized representative of the Applicant (above) I hereby request that we be assigned a MIDI System Exclusive ID number.

An asterick (*) indicates a required field.