Facility Members
Commercial Members
Associate Member
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Commercial Membership Application Form
Initial registration fee:
$2,500.00
(US funds)
Annual Membership dues:
$1,000.00
(US funds)
Total Dues:
$3,500.00
(US funds)
Mail your check,
payable to MUSE
. Please note that membership is not automatic.
A committee of the MUSE Board will review this application.
Company Name:
Website:
Parent Company:
(if applicable)
Primary Contact:
Title:
Address:
City:
State/Province
Choose One
Alberta
Alaska
Alabama
Arkansas
Arizona
British Columbia
California
Colorado
Connecticut
District of Columbia
Delaware
Florida
Georgia
Hawaii
Iowa
Idaho
Illinois
Indiana
Kansas
Kentucky
Louisiana
Massachusetts
Manitoba
Maryland
Maine
Michigan
Minnesota
Missouri
Mississippi
Montana
New Brunswick
North Carolina
North Dakota
Nebraska
Newfoundland
New Hampshire
New Jersey
New Mexico
Nova Scotia
Northwest Territories
Nevada
New York
Ohio
Oklahoma
Ontario
Oregon
Pennsylvania
Prince Edward Island
Quebec
Rhode Island
South Carolina
South Dakota
Saskatchewan
Tennessee
Texas
Utah
Virginia
Vermont
Washington
Wisconsin
West Virginia
Wyoming
Yukon
Other
Country
Choose One
Canada
Pakistan
South Africa
United Arab Emirates
United Kingdom
United States
Zip/Postal Code:
Phone:
Fax:
Email:
Please list those MUSE member facilities that are current clients of your company:
Please name a current MUSE Facility member that would recommend your membership to MUSE:
Please give a detailed description of your business:
Please indicate how your products and/or services will add value to the
MUSE organization:
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