Medical Alley Partner Application

Redirecting you to a secure payment page…

Join Medical Alley: First-time Member

When you provide thorough information, it helps us connect you with our vibrant community in the ways you will find most useful and ensures your public profile in our partner directory is accurate.

Tell us about your organization. We use this information to help guide you to the appropriate membership level and to custom tailor the content, events, and information we share with your organization.

Include a submember in your membership registration

Wondering if you are already a member? Need to renew?

Search our partner directory to see if you organization has an active partnership. If so, visit our renew page to renew your partnership.

Organization Name *

Address Line 1 *

Address Line 2

City *

State/Province

Non-US and Canadian partners

State/Province

US and Canadian partners

Country *

Secure Payment

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Company Website

Company LinkedIn

Company Twitter

Company Founded Date

Number of Employees In Minnesota *

Organization Status

Public

Private

Organization Description

The description you enter will appear in your public profile of the partner directory.

Main Contact Information

Tell us who you’d like to be the point person in your organization. This will help us ensure the right people are receiving the right information, ensuring your organization maximizes the benefit of membership with Medical Alley Association.

First Name *

Last Name *

Job Title *

Email *

Phone *

Data Privacy & Consent

Your privacy is important to us. To better protect your privacy, we provide this notice explaining our information practices and the choices you can make about the way your information is collected and used. You are always free to browse our website without identifying yourself. If you choose to take advantage of our services, we may ask you for some personal information.

Find our full privacy policy here

Secure Payment

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Include a submember

{{subMemberDisplayName}} {{index+1}}: {{getSubMemberName(index)}}

Choose Existing Contact(s)

Membership Level *

I would like to automatically renew my membership

First Name *

Last Name *

Job Title *

Email *

Phone

Add {{subMemberDisplayName}}

Secure Payment

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

{{orderSummary.membershipOrderItem.startDate}} - {{orderSummary.membershipOrderItem.endDate}}

{{orderSummary.membershipsTotal==0?'Free':formatAmount(orderSummary.membershipsTotal)}}

Membership auto-renews monthly for {{ formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipInstallment.cost) }} until {{ orderSummary.membershipOrderItem.membershipInstallment.endDate }}

Membership auto-renews on {{orderSummary.membershipOrderItem.membershipAutoRenew.renewDate}} for {{formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipAutoRenew.cost)}}

{{orderSummary.membershipOrderItem.cost==0?'Free':formatAmount(orderSummary.membershipOrderItem.cost)}} {{orderSummary.membershipOrderItem.termName}}

{{orderSummary.membershipOrderItem.startDate}} - {{orderSummary.membershipOrderItem.endDate}}

Membership auto-renews monthly for {{ formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipInstallment.cost) }} until {{ orderSummary.membershipOrderItem.membershipInstallment.endDate }}

Membership auto-renews on {{orderSummary.membershipOrderItem.membershipAutoRenew.renewDate}} for {{formatAutoRenewAmount(orderSummary.membershipOrderItem.membershipAutoRenew.cost)}}

{{sm.userName}} ({{subMemberDisplayName}})

{{sm.startDate}} - {{sm.endDate}}

Membership auto-renews monthly for {{ formatAutoRenewAmount(sm.membershipInstallment.cost) }} until {{ sm.membershipInstallment.endDate }}

Membership auto-renews on {{sm.membershipAutoRenew.renewDate}} for {{formatAutoRenewAmount(sm.membershipAutoRenew.cost)}}

Frequency selected: {{recurringUnitText}}. Next add-on payment processes on {{orderSummary.recurringDonationNextDate}} for {{formatAmount(orderSummary.donationAmount)}}

Discount Code

Code:

-{{formatAmount(orderSummary.codeDiscount)}}

Order summary

Subtotal {{formatAmount(orderSummary.subtotal)}}

Discounts -{{formatAmount(orderSummary.discounts)}}

Total {{formatAmount(orderSummary.total)}}

Secure Payment

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Card

Pay Later

or enter your card details below

Cardholder First Name *

Cardholder Last Name *

Cardholder Email

Card *

Payment Form Unable to Load: Your payment form is blocked by a firewall. This is most commonly due to use of an anonymous, untrusted IP address. If you are using a VPN to anonymize your IP, we recommend connecting through your local IP to complete your payment.

Billing address is the same as mailing address

Address Line 1

Address Line 2

City

State/Province

Zip *

Country

I prefer to be receive an invoice via email.

Please mail your payment to:
4150 Olson Memorial Hwy
Suite 430
Golden Valley, MN 55422

Amount:

{{formatAmount(totalAmount)}} USD

Secure Payment

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Membership level allows for a maximum of {{term.subMemberAllowed}} submembers.

	Contact Name	Membership Level
	{{item.contactName}}	{{item.membershipLevel==null?'-':item.membershipLevel}} {{item.startDate}} - {{item.endDate}}
No contacts.