Group Registration

Please fill in your administrative details here. This account will receive all renewal notifications. Information for each member in your organization will be entered on the next step.
Organization/Company*
First Name*
Last Name*
Email Address*
Enter Email Confirm Email
Password*
Enter Password Confirm Password

Strength indicator
Will you be requiring a membership for yourself?*
- No - I am strictly an organization manager/administrator and do not require a CMIA Chapter Membership.
- Yes - I require a CMIA Chapter Membership for myself.
Select a Membership Level*
- Individual Membership
- Statewide Corporate Membership
Individual Membership
For individuals who are employed by a hospital and/or medical equipment company and actively engaged in the manufacture, support, use, and/or maintenance of medical equipment.

This level of membership includes one voting right.
Statewide Corporate Membership
For business organizations which manufacture, sell or service medical instruments or other products or services used in conjunction with medical instrumentation.

This level of membership includes one voting right.
Membership Fee
$0.00
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Membership Fee*
Chapter*
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Membership Level*

Add all members of your organization below. Please note that it is not necessary to add yourself to this list.
- Organization Managers are required to pay dues for members as they add them, and will receive all renewal notifications.
- All members added will receive an email notification containing a link where they can set their own passwords.

Members

First Name	Last Name	Email Address	Membership Type	Chapter	Actions

There are no Members.

Total
$0.00
Credit Card*
Card Details
Cardholder Name
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Total Membership Fees*
Subscribe to the CMIA Email List
Sign me up for the CMIA Email List (you can unsubscribe at any time).
Consent*
I consent to the data being submitted in this form to be collected and stored by the California Medical Instrumentation Association (CMIA).*
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Date Paid
Reference Number

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