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Corporation / Organization Membership Form
Annual Membership Fee
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$150
Your credit card will be renewed automatically on your sign-up date to ensure your membership for the next year.
Yearly
Corporation Name
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Contact Person
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First Name
Last Name
Address
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Address Line 1
Address Line 2
City
City
State
State/Province
ZIP/Postal Code
Country
Phone
*
Email
*
Verify Email
*
Website, beginning with http://www.
Plese tell us about your company and how it relates to end of life work (for internal use only)
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Upload Company Logo
Corporation/Organization Directory
I acknowledge that by agreeing to have my contact information listed on the NEDA Online Directory I may be contacted by individuals, companies, or groups not associated with NEDA. My contact information will be public and cannot be controlled by NEDA.
Yes, I want to be included in the website Directory
No, I do not want to be included in the website Directory
Directory Agreement
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"By clicking the box below, I am indicating that I understand and accept the following terms: 1) Inclusion of my information on the website directory does not constitute endorsement by NEDA or my training organization, if I have one. 2) I am fully responsible for my own contracts, promotion, and interaction with the public. 3) I have read and agree to honor the NEDA Code of Ethics, Conduct, and Scope of Practice. 4) I understand that my listing on the website directory will only be included as long as I am an active member of NEDA (renew each year)."
Yes, I agree
Add 3% to my total amount to help cover the payment processing fees
