{"id":2041,"date":"2022-05-11T09:04:31","date_gmt":"2022-05-11T16:04:31","guid":{"rendered":"https:\/\/nwta.biz\/?page_id=2041"},"modified":"2022-12-07T08:52:50","modified_gmt":"2022-12-07T16:52:50","slug":"join-as-a-provider-member","status":"publish","type":"page","link":"https:\/\/nwta.biz\/join-as-a-provider-member\/","title":{"rendered":"Join as a Provider Member"},"content":{"rendered":"\n\n                            <h2>Join as a Provider Member<\/h2>\n\t\t\t\t\t\t\t&quot;*&quot; indicates required fields\n                        <form method='post' enctype='multipart\/form-data' target='gform_ajax_frame_3' id='gform_3'  action='\/?page_id=2041&#038;fl_builder#gf_3'>\n                        <label class='gfield_label' for='input_3_4'>Business Name*<\/label><input name='input_4' id='input_3_4' type='text' value='' class='large'   tabindex='100'  aria-required=\"true\" aria-invalid=\"false\"   \/> <label class='gfield_label' for='input_3_6'>Website<\/label>\n                    <input name='input_6' id='input_3_6' type='text' value='' class='large' tabindex='101'   placeholder='https:\/\/'  aria-invalid=\"false\"\/>\n                <fieldset id=\"field_3_5\"   data-js-reload=\"field_3_5\"><legend class='gfield_label gfield_label_before_complex'>Mailing Address*<\/legend>    \n                                        <input type='text' name='input_5.1' id='input_3_5_1' value='' tabindex='102'   aria-required='true'    \/>\n                                        <label for='input_3_5_1' id='input_3_5_1_label'>Street Address<\/label>\n                                        <input type='text' name='input_5.2' id='input_3_5_2' value='' tabindex='103'    aria-required='false'   \/>\n                                        <label for='input_3_5_2' id='input_3_5_2_label'>Address Line 2<\/label>\n                                    <input type='text' name='input_5.3' id='input_3_5_3' value='' tabindex='104'   aria-required='true'    \/>\n                                    <label for='input_3_5_3' id='input_3_5_3_label'>City<\/label>\n                                        <input type='text' name='input_5.4' id='input_3_5_4' value='' tabindex='106'     aria-required='true'    \/>\n                                        <label for='input_3_5_4' id='input_3_5_4_label'>State \/ Province \/ Region<\/label>\n                                    <input type='text' name='input_5.5' id='input_3_5_5' value='' tabindex='107'   aria-required='true'    \/>\n                                    <label for='input_3_5_5' id='input_3_5_5_label'>ZIP \/ Postal Code<\/label>\n                                        <select name='input_5.6' id='input_3_5_6' tabindex='108'  aria-required='true'><option value='' selected='selected'><\/option><option value='Afghanistan'>Afghanistan<\/option><option value='Albania'>Albania<\/option><option value='Algeria'>Algeria<\/option><option value='American Samoa'>American Samoa<\/option><option value='Andorra'>Andorra<\/option><option value='Angola'>Angola<\/option><option value='Anguilla'>Anguilla<\/option><option value='Antarctica'>Antarctica<\/option><option value='Antigua and Barbuda'>Antigua and Barbuda<\/option><option value='Argentina'>Argentina<\/option><option value='Armenia'>Armenia<\/option><option value='Aruba'>Aruba<\/option><option value='Australia'>Australia<\/option><option value='Austria'>Austria<\/option><option value='Azerbaijan'>Azerbaijan<\/option><option value='Bahamas'>Bahamas<\/option><option value='Bahrain'>Bahrain<\/option><option value='Bangladesh'>Bangladesh<\/option><option value='Barbados'>Barbados<\/option><option value='Belarus'>Belarus<\/option><option value='Belgium'>Belgium<\/option><option value='Belize'>Belize<\/option><option value='Benin'>Benin<\/option><option value='Bermuda'>Bermuda<\/option><option value='Bhutan'>Bhutan<\/option><option value='Bolivia'>Bolivia<\/option><option value='Bonaire, Sint Eustatius and Saba'>Bonaire, Sint Eustatius and Saba<\/option><option value='Bosnia and Herzegovina'>Bosnia and Herzegovina<\/option><option value='Botswana'>Botswana<\/option><option value='Bouvet Island'>Bouvet Island<\/option><option value='Brazil'>Brazil<\/option><option value='British Indian Ocean Territory'>British Indian Ocean Territory<\/option><option value='Brunei Darussalam'>Brunei Darussalam<\/option><option value='Bulgaria'>Bulgaria<\/option><option value='Burkina Faso'>Burkina Faso<\/option><option value='Burundi'>Burundi<\/option><option value='Cambodia'>Cambodia<\/option><option value='Cameroon'>Cameroon<\/option><option value='Canada'>Canada<\/option><option value='Cape Verde'>Cape Verde<\/option><option value='Cayman Islands'>Cayman Islands<\/option><option value='Central African Republic'>Central African Republic<\/option><option value='Chad'>Chad<\/option><option value='Chile'>Chile<\/option><option value='China'>China<\/option><option value='Christmas Island'>Christmas Island<\/option><option value='Cocos Islands'>Cocos Islands<\/option><option value='Colombia'>Colombia<\/option><option value='Comoros'>Comoros<\/option><option value='Congo, Democratic Republic of the'>Congo, Democratic Republic of the<\/option><option value='Congo, Republic of the'>Congo, Republic of the<\/option><option value='Cook Islands'>Cook Islands<\/option><option value='Costa Rica'>Costa Rica<\/option><option value='Croatia'>Croatia<\/option><option value='Cuba'>Cuba<\/option><option value='Cura\u00e7ao'>Cura\u00e7ao<\/option><option value='Cyprus'>Cyprus<\/option><option value='Czech Republic'>Czech Republic<\/option><option value='C\u00f4te d&#039;Ivoire'>C\u00f4te d&#039;Ivoire<\/option><option value='Denmark'>Denmark<\/option><option value='Djibouti'>Djibouti<\/option><option value='Dominica'>Dominica<\/option><option value='Dominican Republic'>Dominican Republic<\/option><option value='Ecuador'>Ecuador<\/option><option value='Egypt'>Egypt<\/option><option value='El Salvador'>El Salvador<\/option><option value='Equatorial Guinea'>Equatorial Guinea<\/option><option value='Eritrea'>Eritrea<\/option><option value='Estonia'>Estonia<\/option><option value='Eswatini (Swaziland)'>Eswatini (Swaziland)<\/option><option value='Ethiopia'>Ethiopia<\/option><option value='Falkland Islands'>Falkland Islands<\/option><option value='Faroe Islands'>Faroe Islands<\/option><option value='Fiji'>Fiji<\/option><option value='Finland'>Finland<\/option><option value='France'>France<\/option><option value='French Guiana'>French Guiana<\/option><option value='French Polynesia'>French Polynesia<\/option><option value='French Southern Territories'>French Southern Territories<\/option><option value='Gabon'>Gabon<\/option><option value='Gambia'>Gambia<\/option><option value='Georgia'>Georgia<\/option><option value='Germany'>Germany<\/option><option value='Ghana'>Ghana<\/option><option value='Gibraltar'>Gibraltar<\/option><option value='Greece'>Greece<\/option><option value='Greenland'>Greenland<\/option><option value='Grenada'>Grenada<\/option><option value='Guadeloupe'>Guadeloupe<\/option><option value='Guam'>Guam<\/option><option value='Guatemala'>Guatemala<\/option><option value='Guernsey'>Guernsey<\/option><option value='Guinea'>Guinea<\/option><option value='Guinea-Bissau'>Guinea-Bissau<\/option><option value='Guyana'>Guyana<\/option><option value='Haiti'>Haiti<\/option><option value='Heard and McDonald Islands'>Heard and McDonald Islands<\/option><option value='Holy See'>Holy See<\/option><option value='Honduras'>Honduras<\/option><option value='Hong Kong'>Hong Kong<\/option><option value='Hungary'>Hungary<\/option><option value='Iceland'>Iceland<\/option><option value='India'>India<\/option><option value='Indonesia'>Indonesia<\/option><option value='Iran'>Iran<\/option><option value='Iraq'>Iraq<\/option><option value='Ireland'>Ireland<\/option><option value='Isle of Man'>Isle of Man<\/option><option value='Israel'>Israel<\/option><option value='Italy'>Italy<\/option><option value='Jamaica'>Jamaica<\/option><option value='Japan'>Japan<\/option><option value='Jersey'>Jersey<\/option><option value='Jordan'>Jordan<\/option><option value='Kazakhstan'>Kazakhstan<\/option><option value='Kenya'>Kenya<\/option><option value='Kiribati'>Kiribati<\/option><option value='Kuwait'>Kuwait<\/option><option value='Kyrgyzstan'>Kyrgyzstan<\/option><option value='Lao People&#039;s Democratic Republic'>Lao People&#039;s Democratic Republic<\/option><option value='Latvia'>Latvia<\/option><option value='Lebanon'>Lebanon<\/option><option value='Lesotho'>Lesotho<\/option><option value='Liberia'>Liberia<\/option><option value='Libya'>Libya<\/option><option value='Liechtenstein'>Liechtenstein<\/option><option value='Lithuania'>Lithuania<\/option><option value='Luxembourg'>Luxembourg<\/option><option value='Macau'>Macau<\/option><option value='Macedonia'>Macedonia<\/option><option value='Madagascar'>Madagascar<\/option><option value='Malawi'>Malawi<\/option><option value='Malaysia'>Malaysia<\/option><option value='Maldives'>Maldives<\/option><option value='Mali'>Mali<\/option><option value='Malta'>Malta<\/option><option value='Marshall Islands'>Marshall Islands<\/option><option value='Martinique'>Martinique<\/option><option value='Mauritania'>Mauritania<\/option><option value='Mauritius'>Mauritius<\/option><option value='Mayotte'>Mayotte<\/option><option value='Mexico'>Mexico<\/option><option value='Micronesia'>Micronesia<\/option><option value='Moldova'>Moldova<\/option><option value='Monaco'>Monaco<\/option><option value='Mongolia'>Mongolia<\/option><option value='Montenegro'>Montenegro<\/option><option value='Montserrat'>Montserrat<\/option><option value='Morocco'>Morocco<\/option><option value='Mozambique'>Mozambique<\/option><option value='Myanmar'>Myanmar<\/option><option value='Namibia'>Namibia<\/option><option value='Nauru'>Nauru<\/option><option value='Nepal'>Nepal<\/option><option value='Netherlands'>Netherlands<\/option><option value='New Caledonia'>New Caledonia<\/option><option value='New Zealand'>New Zealand<\/option><option value='Nicaragua'>Nicaragua<\/option><option value='Niger'>Niger<\/option><option value='Nigeria'>Nigeria<\/option><option value='Niue'>Niue<\/option><option value='Norfolk Island'>Norfolk Island<\/option><option value='North Korea'>North Korea<\/option><option value='Northern Mariana Islands'>Northern Mariana Islands<\/option><option value='Norway'>Norway<\/option><option value='Oman'>Oman<\/option><option value='Pakistan'>Pakistan<\/option><option value='Palau'>Palau<\/option><option value='Palestine, State of'>Palestine, State of<\/option><option value='Panama'>Panama<\/option><option value='Papua New Guinea'>Papua New Guinea<\/option><option value='Paraguay'>Paraguay<\/option><option value='Peru'>Peru<\/option><option value='Philippines'>Philippines<\/option><option value='Pitcairn'>Pitcairn<\/option><option value='Poland'>Poland<\/option><option value='Portugal'>Portugal<\/option><option value='Puerto Rico'>Puerto Rico<\/option><option value='Qatar'>Qatar<\/option><option value='Romania'>Romania<\/option><option value='Russia'>Russia<\/option><option value='Rwanda'>Rwanda<\/option><option value='R\u00e9union'>R\u00e9union<\/option><option value='Saint Barth\u00e9lemy'>Saint Barth\u00e9lemy<\/option><option value='Saint Helena'>Saint Helena<\/option><option value='Saint Kitts and Nevis'>Saint Kitts and Nevis<\/option><option value='Saint Lucia'>Saint Lucia<\/option><option value='Saint Martin'>Saint Martin<\/option><option value='Saint Pierre and Miquelon'>Saint Pierre and Miquelon<\/option><option value='Saint Vincent and the Grenadines'>Saint Vincent and the Grenadines<\/option><option value='Samoa'>Samoa<\/option><option value='San Marino'>San Marino<\/option><option value='Sao Tome and Principe'>Sao Tome and Principe<\/option><option value='Saudi Arabia'>Saudi Arabia<\/option><option value='Senegal'>Senegal<\/option><option value='Serbia'>Serbia<\/option><option value='Seychelles'>Seychelles<\/option><option value='Sierra Leone'>Sierra Leone<\/option><option value='Singapore'>Singapore<\/option><option value='Sint Maarten'>Sint Maarten<\/option><option value='Slovakia'>Slovakia<\/option><option value='Slovenia'>Slovenia<\/option><option value='Solomon Islands'>Solomon Islands<\/option><option value='Somalia'>Somalia<\/option><option value='South Africa'>South Africa<\/option><option value='South Georgia'>South Georgia<\/option><option value='South Korea'>South Korea<\/option><option value='South Sudan'>South Sudan<\/option><option value='Spain'>Spain<\/option><option value='Sri Lanka'>Sri Lanka<\/option><option value='Sudan'>Sudan<\/option><option value='Suriname'>Suriname<\/option><option value='Svalbard and Jan Mayen Islands'>Svalbard and Jan Mayen Islands<\/option><option value='Sweden'>Sweden<\/option><option value='Switzerland'>Switzerland<\/option><option value='Syria'>Syria<\/option><option value='Taiwan'>Taiwan<\/option><option value='Tajikistan'>Tajikistan<\/option><option value='Tanzania'>Tanzania<\/option><option value='Thailand'>Thailand<\/option><option value='Timor-Leste'>Timor-Leste<\/option><option value='Togo'>Togo<\/option><option value='Tokelau'>Tokelau<\/option><option value='Tonga'>Tonga<\/option><option value='Trinidad and Tobago'>Trinidad and Tobago<\/option><option value='Tunisia'>Tunisia<\/option><option value='Turkey'>Turkey<\/option><option value='Turkmenistan'>Turkmenistan<\/option><option value='Turks and Caicos Islands'>Turks and Caicos Islands<\/option><option value='Tuvalu'>Tuvalu<\/option><option value='US Minor Outlying Islands'>US Minor Outlying Islands<\/option><option value='Uganda'>Uganda<\/option><option value='Ukraine'>Ukraine<\/option><option value='United Arab Emirates'>United Arab Emirates<\/option><option value='United Kingdom'>United Kingdom<\/option><option value='United States'>United States<\/option><option value='Uruguay'>Uruguay<\/option><option value='Uzbekistan'>Uzbekistan<\/option><option value='Vanuatu'>Vanuatu<\/option><option value='Venezuela'>Venezuela<\/option><option value='Vietnam'>Vietnam<\/option><option value='Virgin Islands, British'>Virgin Islands, British<\/option><option value='Virgin Islands, U.S.'>Virgin Islands, U.S.<\/option><option value='Wallis and Futuna'>Wallis and Futuna<\/option><option value='Western Sahara'>Western Sahara<\/option><option value='Yemen'>Yemen<\/option><option value='Zambia'>Zambia<\/option><option value='Zimbabwe'>Zimbabwe<\/option><option value='\u00c5land Islands'>\u00c5land Islands<\/option><\/select>\n                                        <label for='input_3_5_6' id='input_3_5_6_label'>Country<\/label>\n                <\/fieldset><label class='gfield_label' for='input_3_10'>Phone<\/label><input name='input_10' id='input_3_10' type='text' value='' class='large' tabindex='109'   aria-invalid=\"false\"   \/><label class='gfield_label' for='input_3_11'>Fax<\/label><input name='input_11' id='input_3_11' type='text' value='' class='large' tabindex='110'   aria-invalid=\"false\"   \/><label class='gfield_label' for='input_3_12'>Number of Employees<\/label><input name='input_12' id='input_3_12' type='text'    value='' class='large' tabindex='111'     aria-invalid=\"false\"  \/><label class='gfield_label' for='input_3_13'>Describe your business in 25 words or less for our website:<\/label><textarea name='input_13' id='input_3_13' class='textarea small' tabindex='112'     aria-invalid=\"false\"   rows='10' cols='50'><\/textarea><fieldset id=\"field_3_1\"   data-js-reload=\"field_3_1\"><legend class='gfield_label gfield_label_before_complex'>Contact Person*<\/legend>\n                                                    <input type='text' name='input_1.3' id='input_3_1_3' value='' tabindex='114'  aria-required='true'   placeholder='First'  \/>\n                                                    <label for='input_3_1_3' class='hidden_sub_label screen-reader-text'>First<\/label>\n                                                    <input type='text' name='input_1.6' id='input_3_1_6' value='' tabindex='116'  aria-required='true'   placeholder='Last'  \/>\n                                                    <label for='input_3_1_6' class='hidden_sub_label screen-reader-text'>Last<\/label>\n                        <\/fieldset><label class='gfield_label' for='input_3_14'>Email Address<\/label>\n                            <input name='input_14' id='input_3_14' type='text' value='' class='large' tabindex='118'    aria-invalid=\"false\"  \/>\n                        <label class='gfield_label' for='input_3_15'>Phone<\/label><input name='input_15' id='input_3_15' type='text' value='' class='large' tabindex='119'   aria-invalid=\"false\"   \/><strong>President<\/strong><br \/>\n  Michael Wynschenk<br \/>\n  <a href=\"tel:5419632625\">541-604-9898<\/a><br \/>\n<a href=\"mailto:mwynschenk@hunterfiber.com\">mwynschenk@hunterfiber.com<\/a><strong>Vice-President<\/strong><br \/>\n  Duncan\u00a0Scott<br \/>\n<a href=\"mailto:dscott@onlinenw.net\">dscott@onlinenw.net<\/a><strong>Secretary\/Treasurer<\/strong><br \/>\n  Jim Teece<br \/>\n  <a href=\"tel:5412278188\">541-227-8188<\/a><br \/>\n  <a href=\"mailto:jim@projecta.com\">jim@projecta.com<\/a>Membership in the NWTA must be approved by the board of directors. If your application is approved your dues would be $750 annually and you would have one seat on the Board of Directors. Please complete this form and email it to the following officers of the Association:<label class='gfield_label' for='input_3_22'>Referred by NWTA Member<\/label><input name='input_22' id='input_3_22' type='text' value='' class='large'   tabindex='120'   aria-invalid=\"false\"   \/> If you have questions please contact one of the Officers of NTWA listed above.<br \/><br \/>\nWe appreciate your support! Once approved, your company name (with a link to your website) will be listed on our website as a Member and we hope you enjoy many benefits from being a Member in our organization.<br \/><br \/>\nIf accepted, applicant hereby agrees to abide by the NWTA bylaws and accepts the terms and conditions contained therein.<label class='gfield_label' for='input_3_24'>Name &amp; Title<\/label><input name='input_24' id='input_3_24' type='text' value='' class='large'   tabindex='121'   aria-invalid=\"false\"   \/> <label class='gfield_label' for='input_3_8'>Upload Company Logo<\/label><input type='hidden' name='MAX_FILE_SIZE' value='100663296' \/><input name='input_8' id='input_3_8' type='file' class='large' aria-describedby=\"gfield_upload_rules_3_8\" onchange='javascript:gformValidateFileSize( this, 100663296 );' tabindex='122' \/>Accepted file types: jpg, png, gif, bmp, pdf, Max. file size: 96 MB.<label class='gfield_label' for='input_3_9'>CAPTCHA<\/label>\n         <input type='submit' id='gform_submit_button_3' class='gform_button button' value='Submit' tabindex='124' onclick='if(window[\"gf_submitting_3\"]){return false;}  window[\"gf_submitting_3\"]=true; 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