Membership Application

Membership Application for PoE Consortium

PoE Consortium Membership Application

Company Name(Required)

Description(Required)

Website(Required)

URL to Company Logo

Please include a link to your company logo for marketing purposes.

Year Company was Founded(Required)

Membership Level(Required)

Your Address

Street Address Address Line 2 City ZIP Code

Contact Information

Who is the main contact and primary representative for your company?

Primary Contact(Required)

First Last

Job Title(Required)

Your Email Address(Required)

Email Address Confirm Email Address

Your Phone(Required)

PoE Consortium Committees

Please select up to two committees you are interested in joining.

Billing Information

Please fill out this information if the billing contact and information is different from the contact person above.

Name

First Last

Address

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone

Additional comments

Consent to Billing(Required)

Yes

By submitting this application, the company applying for membership in the PoE Consortium agrees to pay the relevant annual dues associated with the level of membership selected above. All members who apply in 2022 will be billed for 2023 membership the first week of January, 2023. There will be several options for payment. All payments must be made within 30 days of invoicing or membership will be revoked. By checking this box, you are agreeing to these terms.

Consent for contact(Required)

Yes

PoE Consortium is committed to protecting and respecting your privacy, and we’ll only use your personal information to administer your account and to provide the products and services you requested from us. From time to time, we would like to contact you about our products and services, as well as other content that may be of interest to you. You can unsubscribe from these communications at any time. For more information on how to unsubscribe, our privacy practices, and how we are committed to protecting and respecting your privacy, please review our Privacy Policy.

Apply for Membership

By clicking submit below, you consent to allow PoE Consortium to store and process the personal information submitted above to provide you the content requested.