MEMBERSHIP APPLICATION

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COMPANY INFORMATION

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MEMBERSHIP INFORMATION

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Research and Academia Membership

Physician (no affiliation)K-12 EducationCommunity CollegesUniversity/College/Institute Less that $550M Bioscience ResearchUniversity/College/Institute $50M - 200M Bioscience ResearchUniversity/College/Institute more than $200M Bioscience Research

Number of employees (Oregon and SW Washington)

Number of employees worldwide

CONTACT INFORMATION

PRIMARY CONTACT (Responsibilities include receipt of all official correspondence, designation of company personnel to serve on OregonBio committees and updates of company information)

Name*

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Title*

Email*

example@example.com

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Address*

Subject Matter Expert*

Subject Matter Expertise

Oregon Bio Newsletter Preference*

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Workforce Training / Bio Pro CommitteeProgramming / Events CommitteeGovernment Affairs and Advocacy CommitteeCentral Oregon Committee

SECONDARY CONTACT (Responsibilities include receipt of membership invoice and payment of membership dues)

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Title*

Email*

example@example.com

Phone*

Address*

Subject Matter Expert

Oregon Bio Newsletter Preference*

ADDITIONAL CONTACTS (CEO, Finance, HR, Operations, Scientist, Engineer, Government Relations, Administrative, Site Head, Legal counsel, Purchasing )

Open to all Industry and Service partner applicants, level must be at or above Standard Membership

Industry Core Membership (Based on number of employees)

Service Partner Core Membership (Based on number of employees)

Non-Profit and Government Members

$825

Hospitals

$2,200

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(hereafter “company”) affirm that company’s membership will automatically renew and be considered due annually upon company’s anniversary date. Membership cancellations must be received 30 days in writing prior to your renewal date via email to membership department at julie@oregonbio.org

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INDUSTRY MEMBERSHIP APPLICATION

Premium Memberships (See Prospectus for Recognition Details)

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