MEMBERSHIP APPLICATION Please email this application, along with your logo (high resolution eps, png, or jpg file) to [email protected] Company name: Address: Primary contact: Title: Email address: Phone: Press Representative: Email address: Primary Phone: _____________________________________________________________________________ __________________________________City__________________ State______ Zip ________ _________________________________ _________________________________ _________________________________ ________________ office mobile Secondary Contact: _________________________ Title: __________________________ Email address: __________________________ Phone: ________________ office mobile ________________________________ ________________________________ ________________________________ Marketing representative: ___________________ Email address ____________________ Primary phone: ____________________ Please provide the forms of social media you use along with the account names. We would like to support you. ____________________________________ ____________________________________ Circle if your business is: MBE _______________________________________ _______________________________________ WBE Veteran-Owned How would you best categorize your organization within the OSW industry? (Please circle or highlight all that apply) SERVICES Accounting Administrative Supplemental Support & Staffing Workforce Development Project Development Project Management Central Mon. Station instrumentation Construction Management Consultants - Electrical Consultants - Environmental Consultants - Health & Safety Consultants - Permits Consultants - Technology & Security Consultants - Transportation Design - Foundation Design - Transition Diving Services Engineering - Civil Engineering - Electrical Engineering - Environmental Engineering - Turbine Engineering - Weld Services Financing Geo-Technical GIS Support Services Grid Sensing & Data Concentration Helicopter Services Land for Prospective Manufacturers Legal Services Logistics Permit Processing Permitting/Ecological Studies Port Infrastructure & Facilities Power Generation Protection & Control Regulatory Authorities/CVA/Permitting Remote Sensing Technology Research Services Surveys - Environmental Surveys - Subsea Surveys - Other Utility Layout CONTRACTORS Civil Construction Marine Construction O&M Vessel Construction Electrical Contracting Utility Construction Barge & Foundation Towing Cable & Pipe Burial Cable - Subsea Installer Cable - Protection System Cable - Subsea Installer Electrical Contracting Electricians - High Voltage Electricians - Low Voltage Harbor Dredging HVAC/Mechanical Contractor Heavy Transporter Services Installation Vessel Provision for Construction Installation - Foundation Installation - OSS Installation - WTG Jack Up Barge Fabrication Land Crane Services Lay Down Area Machining - Large Diameter Machining - Small Part Maintenance Marine Salvage Marine Support Marine Surveillance & Security MET Tower Nacelle Covers O&M Vessel Operation Painting & Blasting Services Piling/Boring Rocks / Rip Rap for Anti‐scouring Rope Access & Rigging ROV Support for Subsea Cable Inst., Insp. & Burial Ship Repair Site Clearance Steel Work for Offshore Substation Switchgear Testing - Non-destructive Transportation Services Upland Cable & Substation/Grid Connection Vessels Vessels - Inspection Weld Inspection Welding Wiring Harnesses - High Voltage w/in Nacelle Wiring Harnesses - High Voltage w/in Tower WTG - Foundation Preassembly EQUIPMENT/MATERIAL SUPPLY Cable Supplier Electrical Component Supplier Equipment Distributor Equipment Rental Manufacturer - Cable Manufacturer - Composite Turbine Blade Manufacturer - Foundations Manufacturer - Other Manufacturer - Steel Manufacturer - Towers Manufacturer - Transition Pieces Personnel Safety Equipment Supplier Rigging Material Supplier Steel Supplier Supply House Transportation Please provide a brief description of your company: What are your membership goals? (Please check or highlight all that apply) ___ Build business to business relationships ___ Increase knowledge of the offshore wind sector ___ Enter new international markets ___ Enter new domestic markets ___ Network with domestic and international business executives ___ Network with domestic and international business executives ___ Stay current on procurement and OSW developments ___ Work on R&D projects with a focus on commercializing new technology ___ Expand international sales/trade ___ Contribute thought leadership to the field ___ Increase company visibility ___ Secure public sector funding for projects ___ Other: _________________________________________________________________________ Are there any specific member companies you are interested in meeting? (Please list Top 5 in priority order) Are there any specific topics you’d like to see for webinars or workshops? Propose a single new activity that the Network is not presently doing that will help your company. Does your company have a budget to attend trade missions/export tours? Yes ___ No ___ Much of the work of the Network is done in our Working Groups. Please look through the Working Group Guide and indicate below which committee(s) you are interested in joining. Feel free to contact any of the Committee Chairs for more information. ___ Infrastructure ___ Innovation and Commercialization ___ Workforce and Economic Development ___ Advocacy ___ Membership, Marketing, & Outreach ___ Lower Eastern Shore Cluster Were you referred by a Business Network member? If so, please list ____________________________________. Please check the box next to the membership level that applies: 2016 Membership Dues Gross Annual Revenue $0 - $1M $1M - $1.5M $1.5M - $5m $5M - $10M $10 - $50M $50M and above International Businesses with no locations in the U.S. State Government agencies Local Government agencies Academic institutions Nonprofits Membership $1,200 $1,500 $2,500 $5,000 $8,500 $10,000 2,550 $1,200 $750 $1,200 $500 Check: Please mail checks to: Attn: Liz Burdock Business Network for Offshore Wind, Inc. 1701 North Gay Street Baltimore, MD 21213 Credit Card: Please contact Adrienne Kubeluis at [email protected] Paying by credit card incurs an additional 2.5% fee. Thank You! We look forward to working with you, accomplishing your membership goals and growing the offshore wind industry. Please follow us on Twitter @BizMDOSWind for OSW industry news updates.