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Professional Affiliate (Vendor) Membership

 

MEMBERSHIP FEE: $250 PER YEAR

Professional Affiliate is any individual, business, or organization supplying goods and/or services to the deathcare industry or whose activities are affiliated with caregiving professions other than a funeral home licensed in Oregon.

 

 

Registration Form - all fields required (if applicable) 

Type of Membership

Professional Affiliate (Vendor) Member   
 
Business Name 
Name of Manager or Owner 
Street Address: 
 

City: 
State: 
Zip Code: 
Phone Number: 
Contact Email Address: 
Website: 

Is the business licensed by the State Mortuary and 

Cemetery Board?
Yes     No

Please complete:
Submit a brief business or service description to demonstrate your relationship to the death care industry or caregiving profession:


 

12725 SW 66th Avenue, Suite 105, Portland, OR 97223
Phone: 503.639.1186 Fax: 503.624.2903
In-State Phone: 800.304.5095 In-State Fax: 800.828.3415
Email:

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