Organization *

Please select your membership status for 2027: *

My organization will renew its membership in AMERIPEN

My organization will NOT renew its membership in AMERIPEN

Please select your membership type, tier, and dues for 2027: *

Company Member - Tier 1 (Global sales greater than $10 billion for most recent fiscal year.) | $30,000

Company Member - Tier 2 (Global sales of $1–10 billion for most recent fiscal year.) | $22,800

Company Member - Tier 3 (Global sales of $10 million–1 billion for most recent fiscal year.) | $15,000

Company Member - Tier 4 (Global sales of less than $10 million for most recent fiscal year.) | $7,800

Associate Member | $7,800

Affiliate Member | $ 10,000

Billing Contact First and Last Name *

Billing Contact Title

Billing Contact Email *

Billing Contact Phone *

Accounts Payable Process/Notes (if applicable): *

If your organization uses a third-party invoice processing system, please indicate which system and describe process here. If not applicable, please write in "N/A."

PO Number *

If a PO number is required by your organization, please list the PO number here for us to include on your invoice. If a PO number is not required, please enter "N/A."

Billing/Payment Schedule *

Please bill us on October 1, 2026, with payment due by December 31, 2026.

Please bill us on January 4, 2027, with payment due by March 31, 2027.

Please contact me to discuss other billing/payment options.

AMERIPEN Governance Documents *

As a reminder, please review AMERIPEN's Bylaws and Antitrust Policy and click below to confirm that you have read and will comply with them.

I have read and will comply with AMERIPEN's Bylaws and Antitrust Policy.

Submitted by (include your first and last name): *