Value Chain Group Individual Membership Application

Your VCG membership entitles you to the benefits established by the VCG Board of Directors. This includes the right to access and use the Value Reference Model and VRM Frameworks in the formats provided. Contributions to VRM development by VCG members becomes the intellectual property of the VCG and its members. Your membership to the VCG will remain active as long as your annual dues or those of your company are paid. Please complete the form below and submit. Fields marked with a red asterisk* are required. This application is for both individuals who are alinging their membership with the company they work for and for those applying independenlty. Contact info@value-chain.org with membership questions. The Value Chain Group, Inc. is a public Not-for-Profit Trade Association.

Section 1: User Information
	Salutation	SELECT ONE Mr. Mrs. Ms. Miss Dr. Prof. Hon.

First Name*

Initials

Last Name*

Display Name

Company*

Title*

Address*

Address 2

City*

State

Zip Code

Country

Work Phone*

Mobile Phone

E-mail*

Web Site

Hide in Search

Yes    No

Hide Address

Yes    No

Hide Email

Yes    No

	Hide Phone	Yes    No
	For networking purposes, only members have full visibilty with other members unless you choose to hide your contact information above.

Primary Delegate

UD2

UD3

UD4

User Name*

Password*

confirm password

Section 2: Membership Information
	Corporate Membership ID   n/a
	Select the member company you work for from this list: This will be confirmed via your company email address. Leave blank if you are applying with no company affiliation.

Company Type*

End User - Practitioner Consultant Vendor - Enabler Research Institute Consortia Government Agency Academia

Industry

Selection Not Available

Region

SELECT ONE Americas Asia Pacific Europe, Middle East, Africa - EMEA

Company Annual Gross Revenue*      Less than $100 million Between $100 and $500 million Over $500 million

Section 3: Membership Type
	Membership Type* $300.00 - Individual Membership

Section 4: Payment
	Payment Method*     Credit card     Check     Wire transfer     Send invoice

Section 5: Subscribe to Groups
	Subscribe to groups Aerospace/Defense Apparel Automotive Building Materials Chemical / Pharmaceuticals Consulting Electronics Food/SCPG Health Services Equipment Industrial Industrial Components Job Shop Medical Devices Metals Oil & Gas Petrochemical and Refining Pulp/Paper Retail Rubber/Plastics Semiconductor Software / IT Services Textiles Trans / Distribution

For security reasons, type in the code below:

If paying by Check or Money Order please make check payable to Value Chain Group, Inc. and mail it to:  Value Chain Group, Inc. 4001 Tall Timber Dr. Allison Park, Pennsylvania 15101 USA To arrange a Wire Transfer please contact the the Value Chain Group info@value-chain.org.    Membership will be made active only upon receipt of payment.