2017 CORPORATE MEMBERSHIP PROGRAM

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1 2017 CORPORATE MEMBERSHIP PROGRAM

2 2017 CORPORATE MEMBERSHIP PROGRAM The American Society for Apheresis (ASFA) is an organization of physicians, scientists, and allied health professionals whose mission is to advance apheresis medicine for patients, donors and practitioners through education, evidence-based practice, research and advocacy. ASFA requests your support to forward its vision to be the leading organization in apheresis dedicated to improving patient and donor care through evidence-based practices and applications. ASFA s main goal is to serve as the voice of investigators and practitioners to advance the development and delivery of programs and services in the field of apheresis medicine, benefiting patients, donors, and the general public. The core values of ASFA are: Excellence, Trust, Transparency and Collaboration. Corporate membership is available at two levels: Corporate Patron and Corporate Supporter. A description of membership benefits follows. We invite you to work with ASFA in stimulating and supporting an active and cohesive apheresis community in North America. Corporate membership runs from sign-up date until December 31, 2017.

3 2017 CORPORATE PATRON MEMBERSHIP $5,000 USD 1 Corporate Patrons receive the following unique benefits of ASFA corporate membership 2 : A right of first refusal on corporate hosting of ASFA webinars including marketing opportunities and/or educational speaker arrangement. Option to submit peer-reviewed articles for ASFA newsflashes, to be approved by the ASFA Executive Committee. Biannual teleconference with the ASFA Executive Committee as requested by the corporate member(s) to the ASFA Head Office. Access to copies of the ASFA Member Directory mailing list, as requested by the corporate member(s) to the ASFA Head Office (maximum of 2 per year). A right of first refusal on all other ASFA sponsorship opportunities as they become available (e.g. ASFA website, awards, and other initiatives). Corporate Patrons also receive the following standard benefits of corporate membership: Access to the Facility Directory on the ASFA website, with benefits exclusive to corporate members including data on international apheresis equipment usage and other pertinent information on apheresis professionals. Access to the members-only section of the ASFA website, members-only documents, and ASFA newsflashes, as distributed to ASFA membership. Option to submit links to corporate resources for posting on the ASFA website. Recognition on the ASFA website with the corporate name and a link to the corporate website. Participation in ASFA webinar program two individual registrations per webinar as requested by the corporate member(s) to the ASFA Head Office. Access to and a listing in the ASFA Member Directory, a current directory of all ASFA members. Advance notification of sponsorship, marketing and symposia opportunities at ASFA meetings.

4 2017 CORPORATE SUPPORTER MEMBERSHIP $2,500 USD 1 Corporate Supporters receive the following standard benefits of corporate membership 2 : Access to the Facility Directory on the ASFA website, with benefits exclusive to corporate members including data on international apheresis equipment usage and other pertinent information on apheresis professionals. Access to the members-only section of the ASFA website, members-only documents, and ASFA newsflashes, as distributed to ASFA membership. Option to submit links to corporate resources for posting on the ASFA website. Recognition on the ASFA website with the corporate name and a link to the corporate website. Participation in ASFA webinar program two individual registrations per webinar as requested by the corporate member(s) to the ASFA Head Office. Access to and a listing in the ASFA Member Directory, a current directory of all ASFA members. Advance notification of sponsorship, marketing and symposia opportunities at ASFA meetings. 1 All Corporate Member Fees are valued in USD. 2 Please note that ASFA Corporate Members have no voting rights and cannot hold office. Benefits of Corporate Membership remain in effect during the calendar year of membership.

5 RESPONSE FORM My company would like to be an ASFA Corporate Member at the following level: 2017 Corporate Patron $5,000 USD 2017 Corporate Supporter $2,500 USD Corporate Membership runs from sign-up date to December 31, Name: Last First Initial Degrees: MD PhD RN MT Other: Job Title: Department: Institution: Address: City: State: Zip: Country: Telephone: Fax: Gender: Male Female PAYMENT INFORMATION Check Payment Checks should be made payable to: American Society for Apheresis (in US funds drawn on a US or Canadian bank) Fed. Tax ID No.: Credit Card Payment Card Type: MasterCard** Visa** American Express** Card No: Expiry Date: CVC: Name on Credit Card: Signature: ** The charges will appear on your credit card statement as American Society for Apheresis Please submit both pages of this Corporate Membership Application Form along with payment to: ASFA HEAD OFFICE West Pender Street, Vancouver, British Columbia, V6C 2T7, Canada Tel: Fax: asfa@apheresis.org Website: Credit card payments may be faxed to the ASFA Head Office at