MSMR Membership is for organizations only. Once an organization joins MSMR, all of its employees enjoy member benefits.
*(Please note all fields are required with the exceptions of Mail Stop and Additional Contacts)
Your Name
Today's Date
Organization Name Type (e.g., university, biotechnology/pharmaceutical firm, industry supplier, etc.) Street Address CityStateZip Is this the headquarters location or a branch/subsidiary? Telephone Number Fax Number Web address
Key Contact Person Title Telephone Number Mail Stop or Box Contact Email ► Please supply similar information for up to four (4) additional contacts below ◄
How did you learn about MSMR?
Membership interest is:immediate3 – 6 month6 – 9 months9 months or longer
Membership level of interest is:FounderGreat BenefactorSponsorSustaining MemberAffiliate
Additional Contact Person Title Telephone Number Mail Stop or Box Contact Email (required)
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