Membership Registration Certificates

MEMBERSHIP REGISTRATION CERTIFICATE

Certificate No.:    Issuance Date:

RECITALS

WHEREAS, the issuing organization, whose legal name appears below as Issuer Name: , is authorized under its governing charter to admit members and issue membership certificates;

WHEREAS, the individual or entity named below has applied for membership and has agreed to comply with the organization's bylaws, rules, and any conditions governing membership described in this Certificate;

WHEREAS, the Issuer has determined that the applicant satisfies the criteria for admission and payment of required fees, and desires to set forth the terms and conditions of such membership by issuance of this Certificate;

MEMBER INFORMATION

Regular    Associate    Honorary

SCOPE OF MEMBERSHIP

The Issuer hereby certifies that the Member named above is admitted to membership effective on Effective Date: and shall be entitled to the rights, privileges, and obligations specified below and in the Issuer's governing documents.

PAYMENT TERMS

Membership Fee Amount: $    Payment Schedule:

Fees are payable in United States currency (unless otherwise agreed in writing) according to the Payment Schedule. All payments are non-refundable except as expressly provided in the Issuer's bylaws or a written agreement signed by an authorized officer.

Late Payment: If any payment due under this Certificate is not received by the Issuer within days of its due date, a late fee of % per month (or the maximum permitted by applicable law, if less) shall be assessed on the outstanding balance.

TERM AND TERMINATION

Term Start Date:    Term End Date:

Either party may terminate the membership for cause by providing written notice to the other party and an opportunity to cure any breach within days, unless immediate termination is permitted under the Issuer's governing documents. Upon termination, the Member shall remain liable for all unpaid fees and obligations accrued through the effective date of termination.

CONFIDENTIALITY

The Member acknowledges that in connection with membership the Member may receive confidential, proprietary, or non-public information of the Issuer. The Member shall hold such information in strict confidence and shall not disclose it to any third party except as required by law or with the Issuer's prior written consent. Confidential information does not include information that is or becomes publicly available through no fault of the Member or that the Member can demonstrate was independently developed without use of the Issuer's confidential information.

GOVERNING LAW

This Certificate and any dispute arising out of or relating to it shall be governed by and construed in accordance with the laws of the jurisdiction specified here: , without regard to choice-of-law principles that would result in the application of any other law.

ENTIRE AGREEMENT

This Certificate, together with the Issuer's organizing documents and bylaws incorporated herein by reference, constitutes the entire agreement between the Issuer and the Member with respect to the subject matter hereof and supersedes all prior and contemporaneous agreements, understandings, negotiations, and discussions, whether oral or written.

MISCELLANEOUS PROVISIONS

Assignment: Membership rights are personal to the Member and are not transferable except as permitted by the Issuer's bylaws or upon written approval by an authorized officer of the Issuer.

Limitation of Liability: To the maximum extent permitted by law, the Issuer shall not be liable for any indirect, incidental, consequential, or punitive damages arising out of or relating to the Member's membership.

CERTIFICATION

NOW, THEREFORE, the Issuer hereby certifies that the individual or entity named above is a duly admitted member under the terms set forth in this Certificate. This Certificate is issued subject to all terms, conditions and restrictions set forth herein and in the Issuer's governing documents.

Acceptance: By signing below, the Member acknowledges receipt of this Certificate, accepts and agrees to be bound by its terms and by the Issuer's governing documents, and confirms the accuracy of the information provided on this form.

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