Membership Application

AMDM Membership Application
Thank you for your interest in an AMDM membership. Please fill out the application below and click submit. The application is typically reviewed and approved within two days. Please contact the AMDM offices at 202-617-0164 with any questions.
Thank you!

Please select the appropriate membership category: *

Individual - $300 <br> (Membership will be under individual's name) 1-10 Employees - $300 11-100 Employees - $600 101-500 Employees - $850 500+ Employees - $1,550 Multi Sites* - $2,200

* Indicates required field

Primary Contact *

First

Last

Title *

Company *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Email *

Website *

Products or Services *

Number of Employees *

Membership Dues Invoice Contact *

First

Last

Dues Contact Email Address: *

Additional contacts to be added to the AMDM database to receive
communications and updates:

Database Contact #2 Name *

Database Contact #2 Email *

Database Contact #3 Name *

Database Contact #3 Email *

Database Contact #4 Name *

Database Contact #4 Email *

Database Contact #5 name *

Database Contact #5 Email *

If you selected a "multisite" membership, please list the additional sites and locations below to be covered by the membership. Additional database contacts should be added in the previous section.

Company 2 name *

Company 2 address, city, state *

Company 3 name *

Company 3 address city state *

Company 4 address *

Company 4 address city state *

AMDM welcomes new members by:
sending an email announcement introducing the company to our Member Contacts.
Please indicate if you wish to be included or excluded from this activity. *

Please include our company. Please EXCLUDE our company.

Select One
(If paying by credit card, a link will be provided on the confirmation page) *

Other Comments *

Submit Membership Application for Review

AMDM Membership ApplicationThank you for your interest in an AMDM membership. Please fill out the application below and click submit. The application is typically reviewed and approved within two days. Please contact the AMDM offices at 202-617-0164 with any questions.Thank you!

AMDM Membership Application
Thank you for your interest in an AMDM membership. Please fill out the application below and click submit. The application is typically reviewed and approved within two days. Please contact the AMDM offices at 202-617-0164 with any questions.
Thank you!