CIMS Annual Organization Membership Form

Be a part of our collective effort to realize evidence-based maternity care by adding the voice of your organization to the Coalition for Improving Maternity Services (CIMS) as an Annual Organization Member.

2008-2009 Organizational Member Benefits

• Raise awareness and demand for evidence-based care by adding the voice of your organization to the nation’s only coalition of maternity care providers, childbirth organizations, birth advocates and consumers.
• Be visibly recognized on the new www.MotherFriendly.org web site.
• Be part of CIMS service projects, such as a coordinated calendar of all CIMS Organizational Member events on the CIMS web site (coming in Fall 2008).
• Be highlighted in and receive the e-CIMS newsletter.
• Receive product discounts (including bulk orders).

Join CIMS today as an Annual Organization Member by returning your payment along with a completed Organizational Membership Form [PDF] or complete the form below to join online with a credit card.

I choose the following membership category:*

Membership* Levels:	2008/09^ Membership Fee:	Recommendations:
Grassroots Member	$100 - $250	For advocacy organizations with revenues less than $25,000 gross annual income
Provider Member	$250 - $500	For individual and group practices with revenues less than $1 million gross annual income
Affiliated Member	$500 - $2,000	For advocacy organizations and corporations with revenues between $25,000 and $1 million gross annual income
Collaborating Member	$2,000 - $5,000	For professional associations, group practices and corporations with revenues greater than $1 million gross annual income

*CIMS has a non-voting membership according to our bylaws
^The 2008/09 organizational membership year runs from Sept. 1, 2008-Aug. 31, 2009.

Organization Name:*

Contact Person:*

Title:

Address:*

City:*

State/Providence:*

Zip:*

Country:*

Telephone:*

Fax:

Email:*

Website:


Payment by:* 
If payment by a check, please download the pdf form and mail it in with your check.
a credit card

Card Type:* 
Visa
Mastercard

Card #:*

Exp. Date:*

Name on Card:*

One-time credit card payment of
$