United States National Committee of the CIE Membership Application / Renewal
Salutation
First Name
*
Last Name
*
Business/Organization name
*
Street address
*
Street address line 2
City
*
State
*
Please Select
AL
AK
AZ
AR
CA
CO
CT
DE
FL
GA
HI
ID
IL
IN
IA
KS
KY
LA
ME
MD
MA
MI
MN
MS
MO
MT
NE
NV
NH
NJ
NM
NY
NC
ND
OH
OK
OR
PA
RI
SC
SD
TN
TX
UT
VT
VA
WA
WV
WI
WY
Zip code
*
Phone number
*
Email address
*
Fax Number
Interested in:
*
Division 1 - Vision and Color
Division 2 - Measurement of Light & Radiation
Division 3 - Interior Environments & Lighting Design
Division 4 - Lighting for Transportation and Exterior Applications
Division 6 - Photobiology and Photochemistry
Division 8 - Imaging Technology
Membership Levels
prev
next
( X )
Individual Membership
$
75.00
Bronze Organizational Membership
$
1,000.00
Silver Organizational Membership
$
3,000.00
Gold Organizational Membership
$
5,000.00
Platinum Organizational Membership
$
10,000.00
Government Organizational Membership
$
3,000.00
Sponsorship and Donation
$
1.00
Amount
Upgrade Bronze to Silver Organizational Membership
$
2,000.00
Upgrade Silver to Gold Organizational Membership
$
2,000.00
Upgrade Gold to Platinum Organizational Membership
$
5,000.00
“NOTE: Payments may be processed via Credit Card or PayPal; for standard credit card payments, please select ‘Submit’ below, and then select ‘Pay using your credit or debit card on the following page.”
Save
Submit
Should be Empty: