Company Information

Industry Sector (check all that apply) *

Designated Company Contact

The Designated Contact is the main point of contact between the member company and the CEPA Foundation. They are responsible for administration of the membership, i.e. processing invoices, membership renewals,  updating company information etc. They will also receive all communications from the Foundation such as event announcements, project updates, year end reviews, requests for participation etc.

CEO / President

Additional Company Contact

Additional contacts will receive general communications from the Foundation such as event announcements, project updates, year end reviews etc.

Add Another Additional Company Contact

Membership Dues

Payment Information

Membership Dues (Please Enter Applicable rate)

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Total Payable