Organizational Membership Application

Who will be the primary contact for this membership?

First Name

Last Name

Job Title

Organization Information

Organization Name *

Street Address Line 1 *

Street Address Line 2

City *

Country *

Province *

Postal Code *

Website *

We are applying for a *

Corporate Membership - for organizations seeking to build internal capacity in maintenance, reliability and asset management

Allied Membership - for organizations who can assist with relevant products & services

Your Expiry Date *

1 year - Expires August 31, 2024

All PEMAC memberships end on August 31st.

Organizational Membership Fee:

1 year membership $459 / year (Prorated to reflect days remaining to August 31st)

Remainder of Current Year

Amount for Full Year(s)

= Total Fee

OPTIONAL: Memberships for Employees

Your Corporate or Allied membership includes a free individual membership for 1 employee. These amounts will also be prorated to reflect the days remaining to August 31st.

Employee memberships can be added for 25% off.

	Regular Price	Employee Price
1 year	$184	$138

Employees can sign up independently at this discounted rate at any time during your company's membership period.

If you would like to include individual memberships on your initial invoice, indicate how many employee memberships you would like to add in the box below.

Please add # employee memberships

Office Use