CCIA Membership Form

Thank you for your interest in joining the Colorado Cleantech Industries Association. Please fill out the information below. You will be contacted by someone from CCIA following submission of your application.

If you have any questions about this application, please contact
Laura Hickernell, laura@coloradocleantech.com.

Thank you!

Fields marked with an * are required.

First Name

Company and Contact Information

Company Name *

Street Address *

Address Line 2

City *

State *

Zip Code *

Country

Company Website *

Company Phone *

Upload your company logo *

20MB max

Primary Contact Information

Primary Contact First Name *

Primary Contact Last Name *

Primary Contact Phone *

Primary Contact Email *

Membership Information

Are you or your company the holders of patents or licensed IP? *

Yes

No

N/A

Is this company a spinout of a University or Research Lab? *

Yes

No

N/A

What is your Technology Readiness Level (1-9 if applicable)?

With ONE being bench Scale TRL 1-5, conceptual stage with physical proof that the concept may work, 3-5 years to market and NINE being commercially Ready TRL 8-9+, production models available in limited quantity, less than 18 months to market.

1

9

CCIA Dues Schedule (Annual) *

1 - 20 employees, $1,000 annual membership fee

21 - 50 employees, $2,500 annual membership fee

51 - 150 employees, $5,000 annual membership fee

151+ employees and research institutions, $10,000 annual membership fee

Additional Information

Please provide full contact information for a secondary contact at your company *

Please include name, title, phone, and email

Additional information request

Please let us know if you have any questions or comments that we might address when we contact you following submission of your application.

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Colorado Cleantech Industries Association | CCIA