Membership Application

Membership Application

Membership Type
Full Member - Large ($2,500)
Full Member - Medium ($1,000)
Full Member - Small ($500)
Associate Member ($250)
Contact Information
Company Name:
Primary Contact Name:
Phone Number:
Address 1:
Address 2:
City, State, Zip:
Primary Contact Email Address:
Secondary Contact Name (optional):
Phone Number:
Address 1:
Address 2:
City, State, Zip:
Secondary Contact Email Address:
 
Checklist of Interests
Standards / Best Practices
Conflict Resolution
Compliance/Rental Reduction
Membership
Education / Workshops
Annual Meeting
 
Company Information:
Electrics
IOU
PUD
Cooperatives
Municipal Utility

Communications

CATV
ILEC
CLEC
Small Telephone

Other

Government Entity
Vendor
Contractor
Number of Contacts:
(Contacts are no. of poles occupied, both owned and rented)
 
Other Comments or Additional Information:
 
Print your completed form and fax it to OJUA 503-364-9919