AWEA Membership Application Form

202.383.2550 I www.awea.org MR. MRS. MS. MR. MRS. MS. YOUR PAYMENT INFORMATION Total Dues: $__________ Please Note: Payment information must be included. If paying by check, the check must be submitted with the application. If paying by wire, please contact membership@awea.org.Check Enclosed: #___________ Visa MasterCard AMEX Card Number Expiration DateName on Card Security Code*Signature Promotion Code (if applicable)* Visa or MC: the 3 digit number on the back of card in signature line. AmEx: the 4 digit number on the front of card above card number.ABOUT YOUHow did you hear about AWEA?What are you hoping to achieve with your AWEA membership?What does your company/organization do within the wind industry? Communications Community Wind Education Financial Grassroots Legislative O&M Offshore R&D Safety Siting Small Wind Supply Chain Transmission Transportation UtilityInterests:CONTACT INFORMATION (please complete all fields)Company Name Company Website DatePhone (Main Number) FaxStreet Address City And State / Province Zip / Postal Code Country Billing Contact Job TitleEmail Phone (Direct)Marketing Contact Job TitleEmail Phone (Direct)MEMBERSHIP DUESMembership fees are based on a calendar year cycle and expire Dec. 31. A percentage of your dues will be spent on lobbying (none of your dues will be spent on AWEA WindPAC). Pursuant to IRS code section 162, this percentage of your dues is not tax deductible. AWEA WINDPAC (optional) I authorize solicitation by WindPAC, the political action committee of AWEA. I understand that our corporation may only grant one authorization to a trade association per calendar year. (Corporate approval is necessary before AWEA may conduct a solicitation.) Signature YearMember Categories Membership Criteria Annual Dues Basic Membership (C1) under $500,000 $2,200 Industry Participants (C2) $0.5 – $2 million $4,500 Established Industry Participants (C3) $2 – $10 million $9,000 Fully-Integrated Players (C4) $10 – $25 million $17,000 Key Industry Players (C5) $25 – $50 million $34,000 Industry Leaders (C6) $50 – $100 million $81,000 Strategic Industry Leaders (C7) over $100 million $156,000 Basic Utility $2,000 Utility Working Group $4,500 Strategic Utility $9,000 Entry-Level Membership $1,700 Academic $500 Non-Profit $500QUESTIONS? Contact membership@awea.org or 202.383.2550www.awea.orgAWEA MEMBERSHIP APPLICATIONHOW TO APPLY:ONLINE: www.awea.orgFAX : 202.293.2527MAIL: Attn: AWEA Membership 1501 M Street NW, Suite 1000 Washington, DC 20005 4 Corporate Membership is based on your stage in the industry, with your U.S. wind energy annual revenue as a guideline. See description of each level.4 Utility Membership is based on the level of benefits desired. The utility membership category is limited to regulated utilities / load-serving entities.4 Entry-Level Membership is an exploratory membership option with limited benefits offering. See detailed description.4 Academic Membership is for educators and academic organizations with a non-profit status. They must also be either a degree-granting institution or an academically focused organization.4 Non-Profit Membership is for non-profit 501(c) organizations only.I, the undersigned, acknowledge that: the membership category selected on this application is accurate; this application becomes a binding agreement upon acceptance by AWEA and is subject to the terms and conditions that constitute a part of, or are included, in this application; any dues specified pursuant to this membership agreement are non-refundable; and the membership agreement terminates at the end of this calendar year, unless extended by the mutual consent of the parties to this agreement. I further hereby acknowledge that my membership in AWEA does not create any agency, joint venture or employment relationship between myself and AWEA. All actions taken by me, unless expressly requested by, and carried out under the supervision of, AWEA, will be considered to be my own independent actions and are not sanctioned, endorsed or approved by AWEA. I further agree to indemnify and hold AWEA, its affiliates, and their respective agents, directors, principals, officers and employees (the “AWEA Parties”) harmless from any and all liabilities, obligations, losses, claims, damages, penalties, actions, costs, or expenses of any kind whatsoever, which may be imposed upon or incurred by any of the AWEA Parties as a result of any claims relating to my actions (unless expressly requested by, and carried out under the supervision, AWEA).Signature Company Name: Company Website: Date: Phone Main Number: Fax: Street Address: City And State Province: Zip Postal Code: Country: Billing Contact: Job Title: salutation: Email: Phone Direct: Marketing Contact: Job Title_2: salutation_2: Email_2: Phone Direct_2: Basic Membership C1: Industry Participants C2: Established Industry Participants C3: FullyIntegrated Players C4: Key Industry Players C5: Industry Leaders C6: Strategic Industry Leaders C7: Basic Utility: Utility Working Group: Strategic Utility: EntryLevel Membership: Academic: NonProfit: How did you hear about AWEA: What are you hoping to achieve with your AWEA membership: What does your companyorganization do within the wind industry: Communications: Community Wind: Education: Financial: Grassroots: Legislative: OM: Offshore: RD: Safety: Siting: Small Wind: Supply Chain: Transmission: Transportation: Utility: Year: included If paying by check the check must be submitted with the application: Visa: MasterCard: AMEX: Check Enclosed 1: Check Enclosed 2: Check Enclosed 3: Name on Card: Security Code: Promotion Code if applicable: