Institutional Group Membership Interest Form Thank you for your interest in an Institutional Group Membership. Please complete as much information as possible. Email info@idec.org with any questions. Institution Name* Contact Name (This individual will serve as the Institutional Contact):* Contact Phone Number:* Contact Email Address:* Please share the Program Name at your Institution Please list the Degrees Offered at your Institution How many Professional Members will be part of your Institutional Group Membership? (Minimum of Three) *Please share the names of your Professional members.*Please share the emails for your Professional members.*How many Graduate Members will be part of your Institutional Group Membership? Note that Graduate Members are free under the Institutional Membership Package* How many Graduate Members will be part of your Institutional Group Membership? Note that Graduate Members are free under the Institutional Membership PackagePlease share the email addresses for your Graduate Members.Will your Institution pay any part of each members membership fee?*YesNoWhat percent of each members fee will the institution pay? (0 - 100%)*
