LONMARKInternational MembershipApplication

Tobetterserveourmembers,LONMARKInternationalpostsamemberandcertifiedproductdirectoryat www.lonmark.org.Asanactivemember,weencourageyoutogainthebenefitofmembershipbyproviding thefollowinginformation.Periodicallywemaypromoteyourorganizationaspartofourmembermarketing objectives.Bycompletingthisinformationyoucanhelpustohelpyoubecomemoresuccessful.Intheevent thePrimaryContactcannotbereached,pleaseprovideanAlternateContact.(TYPEORPRINT) CompanyName: PrimaryContact: Title: Address: City,State,Zip: Country: Phone: EMail: CompanyWebAddress: Sponsors,Partners,Associatesonly AlternateContact:_________________________Title: Address: City,State,Zip: Country: Phone: EMail: MarketingContact:_________________________Title: Address: City,State,Zip: Country: Phone: EMail: Fax: Fax: Fax:

2010LonMarkInternational.LonMarkandtheLonMarkLogoaremanaged,granted,andusedbyLonMarkInternationalunderalicensegrantedbyEchelonCorporation. 070010301RevW

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Informationgatheredinthissectionwillbeusedtoensurethattheapplicantappearsintheappropriate listingsontheLONMARKInternationalwebsite. Pleaseindicatethetypeoforganizationthatbestdescribestheapplicant:

F F F F F F Manufacturer EndUser Systems/NetworkIntegrator LONWORKSIndependentDeveloper(LID) Consultant Individual F F F F F F Distributor EducationalInstitution ResearchInstitution GovernmentAgency Consulting&SpecifyingEngineer(CSE) Other(pleasespecify):______________

Pleaseindicatethesizeofyourcompany:
F F F 110employees 1125employees 26100employees F F F 101250employees 251500employees 500+employees

PleaseindicatetheIndustryMarket(s)served:
F F F Buildings Industrial Telecommunications F F F Home Transportation Utilities

PleaseindicatetheGeographicMarket(s)served:
F F F F F F F F F F F F F F F F F F F F F F F NorthAmerica Asia/Pacific Worldwide F F Europe SouthAmerica

PleaseindicatetheApplicationArea(s)served:
AccessControl Audio/Video Avionics CCTV Elevator EnergyManagement FireSuppression/Detection HVAC IndustrialHybrid Lighting Marine Monitoring PowerDistribution Rail/Train RemoteMetering Security SubstationAutomation Textile WasteManagement WindowCoverings F F F F F F F F F F F F F F F F F F F Alarm Automotive Cable/Television Cogeneration EmergencyLighting FieldBus FluidHandling IndustrialDiscrete IndustrialProcess Manufacturing MaterialsHandling Pharmaceuticals Pulp&Paper Refrigeration F SCADA Semiconductor Supervisory Trucking WaterTreatment Other:

2010 LonMark International. LonMark and the LonMark Logo are managed, granted, and used by LonMark International under a license granted by Echelon Corporation. 070-0103-01 Rev Z1

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Sponsors,Partners,Associatesonly
Pleaseprovideabriefdescriptionofyourbusiness(200wordsorless).Yourcompanyprofilewillbedisplayedon theLONMARKInternationalwebsite(alternatively,emailthetexttoinfo@lonmark.org):

LONMARKInternationalTaskGroups
CompleteuptodateinformationonLONMARKInternationalTaskGroupsisavailableonlineat http://www.lonmark.org/membership/task_groups.shtml.ToparticipateinanyoftheLONMARKInternational TaskGroups,pleaseregisteronlineintheMemberForum.Yourinvolvementwillensurethesuccessofthe standardsandweencourageyourparticipation. WeareinterestedinparticipatinginthefollowingLONMARKInternationalTaskGroups(ex:Lighting,HVAC, Home,Transportation,Connectivity,SystemIntegration,etc.)
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2010 LonMark International. LonMark and the LonMark Logo are managed, granted, and used by LonMark International under a license granted by Echelon Corporation. 070-0103-01 Rev Z1

MembershipLevels
Pleaseindicatetheappropriatemembershiplevelbelow: F Sponsors $20,000/year Membershipisextendedtoanyonewhowishestotakeanactiveleadinthedirectionofthe association F F Partners $5,000/year Membershipisextendedto devicemanufacturersandsystemintegratorsorsolutionproviders. Associates $1,000/year Membershipisextendedtosystemintegratorsandsolutionproviders,endusersincluding buildingowners,facilitymanagers,citymanagers,consultants,andtradeassociationsand industrygroups. Individuals $200/year Membershipisextendedtoindividualsonly,nocompanyorassociationcanbecomean individualmember.

LogoAgreement F OurorganizationwouldliketousetheapplicableLONMARKlogo(sponsor,partner,or associate)aspartofourbrandingprograms.PleasesendmetheLONMARKlogolicense agreement.ThisagreementisrequiredbyanymemberwishingtousetheLONMARKmember logo.Onceexecutedalogofilewillbeavailabletothemember.

PLEASEENCLOSEPAYMENTORPURCHASEORDERFORTHEMEMBERSHIPFEEWITHTHISAPPLICATION Membershipfeesaredueandpayableeachyearonthemembershipanniversarydate. MembershipfeesarelistedinUSDollars. Membershiprightsandprivilegesarecontingentuponacceptanceandpaymentofallfees. Membershipduesdiscountsubjecttomembershipconfirmationinauthorizedaffiliate.

PaymentMethod(mustcheckone): F MembershipFeeenclosed (CheckorPurchaseOrderpayabletoLONMARKInternational) F Wiretransferto:WellsFargoBank,PaloAlto,CA94301US Account#4020017059,Acct.Name:LONMARKInternational Routing/ABANo.121000248,SwiftCode:WFBIUS6S F PleasebilltoCreditCard:FVisaFMasterCard FAmericanExpress Card# ExpirationDate: NameofCardholder(asitappearsoncard) CardSecurityCode#(usuallya3or4digitnumberprintedonthebackofthecard) F PleasecheckhereifyouwerereferreddirectlybyanotherLONMARKInternationalmember. ReferringCompanyName

2010 LonMark International. LonMark and the LonMark Logo are managed, granted, and used by LonMark International under a license granted by Echelon Corporation. 070-0103-01 Rev Z1

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BillingInformation CompanyName: PrimaryBillingContact: Title: Address: City,State,Zip: Country: Phone:_______________________Fax:_______________________Email_____________________ Onbehalfoftheapplicant,Iaffirmthat,ifacceptedforLONMARKInternationalmembership, applicantagreestoabidebytherulesandpoliciesofLONMARKInternationalandauthorizesthe useofapplicantsnameintheformalLONMARKInternationalmembershiplistsandmarketing efforts. Signature: Name(Print): Title: Company: Date: Pleasemailthecompletedapplication,togetherwithpaymentoftheappropriatemembership feeinU.S.dollars,to: Secretary/Treasurer
LONMARKInternational

550MeridianAvenue SanJose,CA95126USA Tel:+14089385266 Fax:+14087903838 Email:secretary@lonmark.org

2010 LonMark International. LonMark and the LonMark Logo are managed, granted, and used by LonMark International under a license granted by Echelon Corporation. 070-0103-01 Rev Z1

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