MITX - Membership - Join - Corporate Membership

Join - Corporate Membership

The information you provide below will be displayed in our member directory; if you do not wish your contact information to be displayed, please select the "I do not want my name to appear in the membership directory. Please use the alternate below" checkbox, and then provide the information you'd like us to publish.

Please note that the name, address, phone and email address of individuals and students who join is available to both members and non members, whereas individual employees of corporate members are only accessible to members who are logged into our website.

If you have questions or concerns about how your information will appear, please review our privacy policy, or contact Brian Shirley at 617.871.2155 x205.

*Please select membership type:

Company Information

*Company:	*Address:
Address2:	*City:
*State:	*Zip code:
*Phone (i.e. 6175550000):	Fax (i.e. 6175550000):
*URL (i.e. http://www.mitx.org):	Blog (i.e. http://www.mitx.org):
*Company Category 1:	*Company Category 2:
Other:
*Company Description (to appear in directory, limit 750 characters):

Primary Contact for Membership Management

*First name:	*Last name:
*Job title:	*Job description:
*Phone (i.e. 6175550000):	Mobile (For event alerts and updates via text, i.e. 6175550000:
*Email (Your email will be used as your login):	*Email preference: HTML Plain text
*Password:	*Password Confirm:
Check here if address is same as entered above, else fill out below
*Address:	Address2:
*City:	*State:
*Zip code:
I do not want my name to appear in the membership directory. Please use the alternate below.
*First name:	*Last name:
*Job title:	*Phone (i.e. 6175550000):
*Email:	(your primary contact email will be used for login, not alternate.)
*Where did you hear about MITX: (if more than one, select your main influence)
I am interested in the following:the following: Speaking opportunities Sponsorship opportunities Volunteer opportunities	I am interested in these types of speaking opportunities (select all that apply):