Corporate Membership Application Online Payment via Credit Card or PayPal can be made after form submission Corporate Membership - $500.00 annually - Benefits for each Corporate Representative include the quarterly SAFE Newsletter, CD of annual Symposium Proceedings, voting privileges for SAFE Board of Directors, annual award nominations, reduced registration to the annual SAFE Symposium and all SAFE-related mailings. After initial annual dues are paid, future corporate membership invoices are sent to the Primary Corporate Representative. Please advise the SAFE office via email of any special billing procedures. Please provide the following information and we will be in touch with you as soon as possible. Name - Company, Organization, Agency Division     Mail Address (line 1) Mail Address (line 2) City State/Province Zip/Post Code Country Country Code Website Telephone Number - - E-mail Two Individuals who will represent your company, organization, or agency as SAFE members.   Primary Corporate Representative First Name Last Name Job Title Mailing Address City, State, Zip Country, Post Code Telephone - - Email   Secondary Corporate Representative First Name Last Name Job Title Mailing Address City, State, Zip Country, Post Code Telephone - - Email Select your organizations business Please Select 01 Aerospace Vehicle 02 Automotive / Land Vehicle 03 Education, Libraries, Academia 04 Electronic Systems 05 Material and Components Supplier 06 Research / Test, and Evaluation 07 Safety Equipment 08 Simulation / Training 09 Other Company Description/Purpose/Products ___ $500 Payment Method Please Select Fax Credit Card Number Mail Check PayPal Back To Top