IEEE SA Entity Membership Application

Please complete all information requested on this form. Use only English characters.
* INDICATES REQUIRED FIELDS - PLEASE COMPLETE

IEEE Account Username

An IEEE Account Username is required. To get a free IEEE Account, go to this URL: https://www.ieee.org/profile/public/createwebaccount/showRegister.html

Organization Information

Organization Type

Organization Name

Parent Company Name (if applicable)

Annual Global Sales Revenue in US$

Organization Headquarters Address

Country

City

State or Territory (US Only)

Province/Region (non-US)

Zip/Postal Code

Main Phone Number

Please use international formatting: + CountryCode AreaCode PhoneNumber

Fax Number

Please use international formatting: + CountryCode AreaCode FaxNumber

Website Address

Industry Sector

Other Industry

Entity Member Representative (EMR) Information

The Entity Member Representative, or EMR, is the primary account contact for the entity. The EMR is responsible for updating the entity profile and for informing the IEEE SA of any change in the entity status (e.g., mergers and acquisitions) that may impact membership dues and voting privileges in entity standards projects. The EMR is also responsible for distributing entity-standard project sponsor ballot invitations to interested parties within their entity. The EMR will be notified regarding entity membership renewal.

The entity is responsible for providing and updating the contact information for the EMR to IEEE SA, so that there is always current information.

First/Given Name

Last/Family/Surname

Prefix

Job Title

Work Address

Country

City

State or Territory (US Only)

Province/Region (non-US)

Zip/Postal Code

Main Phone Number

Please use international formatting: + CountryCode AreaCode PhoneNumber

Email Address

Would the EMR like to subscribe to IEEE SA's Newsletter to stay updated on new activities?

What are your organization's primary interests in joining IEEE SA (Fill in all that apply):

Join a standards working group (Specify the name of the standard working group:)Ballot a draft standard (Specify draft standard:)Other (Specify:)

Standards Working Group

Draft Standard

Other

Entity Member Representative Alternate (EMRA) Information

In instances where the EMR is not available, the Alternate will assume the responsibilities of the EMR.

Same as EMR

First/Given Name

Last/Family/Surname

Prefix

Job Title

Work Address

Country

City

State or Territory (US Only)

Province/Region (non-US)

Zip/Postal Code

Main Phone Number

Please use international formatting: + CountryCode AreaCode PhoneNumber

Main Phone Number

Please use international formatting: + CountryCode AreaCode PhoneNumber

Email Address

Would the EMRA like to subscribe to IEEE SA's electronic Newsletter to stay updated on new activities?

Would the EMRA like to subscribe to IEEE SA's Newsletter to stay updated on new activities?

Billing Contact (BC) Information

Billing contact information should be supplied if someone other than the EMR will handle invoicing and payment of IEEE SA entity member dues.

Same as EMR

First/Given Name

Last/Family/Surname

Prefix

Job Title

Work Address

Country

City

State or Territory (US Only)

Province/Region (non-US)

Zip/Postal Code

Main Phone Number

Please use international formatting: + CountryCode AreaCode PhoneNumber

Main Phone Number

Please use international formatting: + CountryCode AreaCode PhoneNumber

Email Address

Would the Billing Contact like to subscribe to IEEE SA's Newsletter to stay updated on new activities?

2024 Corporate Membership Dues

Annual membership dues are based on global sales revenue for the entity (for the most recent calendar or fiscal year). IEEE SA corporate membership is based on anniversary date. Please select Tier below.

Membership Tiers

Tier 1 – Entity with less than US $5 million annual revenue, academic institutions, associations, nonprofits, government agencies: US$4,200Tier 2 – Entity with US $5 million to $100 million annual revenue: US$8,000Tier 3 – Entity with US $100 million to $500 million annual revenue: US$12,000Tier 4 – Entity with more than US $500 million annual revenue: US$16,000

Membership Price

Payment Information

Upon approval of the application by IEEE SA, an interim “pending membership” will be granted for 60 days from date of invoice with membership privileges that include voting rights in entity standards working groups. Full membership is granted upon payment to the IEEE of the required appropriate membership dues. If your organization requires a hard-copy application or a quote mailed to you, send an email to [email protected]

Payment Options

CheckCredit/Debit CardWire Transfer

Check

Check payments must be made in US dollars and payable to "IEEE Standards Association" Please reference invoice number and “IEEE SA Entity Membership” on the check. Please mail to: Attn: Christopher Krysa, IEEE Standards Association, 445 Hoes Lane, Piscataway, NJ 08854, USA.

I will complete payment via check as instructed above

Credit Card

Credit Card Number

Credit Card Expiration Date (MM)

Credit Card Expiration Date (YYYY)

CVV

IEEE Privacy Policy

IEEE Privacy Policy Link

I have read and accepted the IEEE Privacy Policy

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IEEE SA Entity Membership Application

IEEE SA Entity Membership Application

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