ATIS Membership Application (One Page) Please enable JavaScript in your browser to complete this form.Company Name *Primary Company WebsiteCorporate RepresentativeName *FirstLastTitleAddressAddress Line 1Address Line 2CityState / Province / RegionAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCountryPhone *Email *Use corporate representative as billing contact? *YesNoBilling ContactName (Billing) *FirstLastTitle (Billing)Address (Billing)Address Line 1Address Line 2CityState / Province / RegionAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodeCountry (Billing)Phone (Billing) *Email (Billing) *Marketing ContactName - Marketing ContactFirstLastTitle - Marketing ContactPhone - Marketing ContactEmail - Marketing ContactMedia ContactName - Media ContactFirstLastTitle - Media ContactPhone - Media ContactEmail - Media ContactMembership in ATIS will grant you the option to participate in, and access to the work of, all of ATIS’ standards development Committees and Forums. Below, please let us know below the areas that interest you most.Primary Areas of InterestArchitecture, Services & ApplicationsAll-IP TransitionCybersecurityIdentity Management- SHAKEN / STIRIndustry NumberingInternet of Things / M2MInteroperability & Open Source SolutionsNetwork Functions VirtualizationPublic Safety & Emergency ServicesService Assurance, Performance & ReliabilityService Delivery, Ordering & BillingSustainability & Energy EfficiencyNetwork SynchronizationWireless & 5GOtherOther (Please specify)Additional Areas of Interest3GPP (additional dues required)Next G Alliance (additional dues required)oneM2MThe Protection Engineers Group (PEG) Conference (additional fee required)The Workshop on Synchronization and Timing Systems (WSTS) (additional fee required)What brought you to ATIS?ATIS MemberTradeshow or ConferenceIndustry ArticlePublished StandardsWebsiteOtherOther (Please specify)Revenue for Membership Dues CalculationATIS dues are based on corporate financial information with applicable revenue derived from: 1) the provision of communication, entertainment, and information technologies services or the resale of those services; 2) the manufacture of communications, entertainment and information technologies equipment and/or the development of software for such equipment; and 3) the provision of operations support used in providing information, entertainment, and communications technologies services. ATIS will verify the information supplied below and provide you with a quote for your Membership.North American RevenueNon-North American RevenueATIS Operating Procedures *Applicant agrees that, upon approval of participation in ATIS, it will abide by the ATIS Operating Procedures.Export Administration Regulations (EAR) Entity List Confirmation *Applicant confirms it: (a) is not included on the U.S. Department of Commerce’s Export Administration Regulations (EAR) Entity List, subject to other U.S. export control laws, Executive Orders, rules or regulations (collectively “U.S. Export Regulations”) that restrict its receipt of or access to information, data, or technology (collectively “Information”) that is of the sort that is disclosed, exchanged, or transferred in the ordinary course of ATIS activities, and at the time of this application is not in violation of any U.S. Export Regulations that restrict its receipt or transfer of Information; and (b) will immediately notify ATIS if the foregoing confirmation becomes in any way inaccurate once it becomes an ATIS member. It is understood that a failure to provide the foregoing confirmation will cause rejection of Applicant’s request for membership in ATIS, and a failure to provide the required notification once a member will result in suspension of Applicant’s membership. MessageSubmit