IEE Membership Application

Thank you for your interest in joining the IEE’s established family and closely held business network! Please complete the form here to submit your application on behalf of your company:

"*" indicates required fields

Contact Information:

All information is strictly confidential and will be used for membership purposes only.

Organization

Prefix

First Name

Last Name

Street Address

Address Line 2

City

State

Zip / Postal Code

Mobile Phone

Office Phone

Verify Email

Email Validation Check

Email Validation Error

Company Website

About your organiztion:

What is your company's primary business?

Name of Owner/President/CEO

Year Founded

NAICS Code

# of Employees

Annual Revenue (approx.)

Is your firm:

Family OwnedClosely HeldOther

Are you a Pitt alum?

YesNo

Membership Level you are applying for:

Platinum ($3,600/yr.)Gold ($2,650/yr.)Silver w/Peer Forum ($1,650/yr.)Silver ($1,200/yr.)Please review the benefits of each membership level here (https://www.entrepreneur.pitt.edu/become-a-member/membership-levels/) to see what works best for you and your company.

The IEE maintains a strict non-solicitation policy for its members. IEE members agree that they will not engage in direct sales and business development activities at IEE member events. If a member is identified as having violated this policy, they risk revocation of their IEE membership.

I understand

Applying for membership with the the IEE does not guarantee membership. The IEE, as part of the Office of Innovation & Entrepreneurship at the University of Pittsburgh, reserves final decision on membership applications and can accept or deny for any reason it deems appropriate to the organization, its members, or its stakeholders.

I understand

Signature

Date

Consent

I agree to the privacy policy.

Contact Information