EMBC Business Associate Membership Application

Take your organizational visibility beyond one or two sponsorship opportunities by obtaining the year-round benefits available to business associate members. The business associate membership offers organizations that support EMBC’s mission a package of benefits and opportunities that enable maximum exposure to our emergency medicine group practice members. EMBC works to promote our business associate members through year-round visibility and recognition.

Any healthcare partner, supplier, or vendor is eligible.*

Your company will benefit by easily making contact with all EMBC member groups. Your benefits include:

10% discount on EMBC sponsorship packages (webinars and in-person receptions)
Year-long recognition with company logo on the EMBC website, www.embusinesscoalition.org
Waived application fee for endorsed partnership application if an RFP is developed with member’s service line
Attendance to EMBC social events at the member rate
Ability to use approved EMBC logo to promote company’s membership
Semi-annual EMBC membership list. Includes contact name, practice name, address and phone number (no emails).

*BUSINESS ASSOCIATE MEMBERSHIP ELIGIBILTY: EMBC reserves the right to determine acceptability of applications for membership. Applications will be accepted or rejected based on criteria including, but not limited to the product or service and the professional or educational benefit to the EMBC membership and products or services consistent with the mission, purpose and goals of EMBC.

Question Title

* 1. Business Associate Primary Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 2. Would you like to provide the contact information for additional company representatives?

Yes

Question Title

* 3. Additional Business Associate Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number

Question Title

* 4. Additional Business Associate Contact Information

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Country

Email Address

Phone Number