AMISA Supporting Partner Application

AMISA Membership Year Cycle: July 1 - June 30

Thank you for your interest in becoming a Supporting Partner of AMISA. We look forward to working together and thank you for your support of our organization and our region. Please complete the form below and Submit. Upon receipt of your application, we will review your application and if approved we will invoice you for the annual membership fee.

Company/Organization name

Country/Region

Address

City

Zip / Postal code

Upload Company/Organization Logo (15MB max)

Logos should be square images (ie. 200px x 200px) File types supported for upload: JPG, PNG, GIF, JPEG, JPE, JFIF, BMP, HEIC, HEIF, TIFF, TIF, WEBP, JPEG 2000 and RAW

Primary Contact Information

Please provide the contact information for the primary representative of the organization. This information will be the public-facing contact for our communication and marketing.

First name

Last name