Become a 6Beds Affiliate Vendor Affiliate Vendor Membership Choose Membership $3,988 - (Tier 1 Annual) $1994 - (Tier 1 Semi-Annual) $997 - (Tier 1 Quarterly) $1,488 - (Tier 2 Annual) $744 - (Tier 2 Semi-Annual) $372 - (Tier 2 Quarterly) $600 (Independent Living Provider) Individual/Business Name*Business Email Address* Phone Number*Fax NumberWebsiteBusiness Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Service and/or Product*Rental Location*Number of Beds*Please enter a number from 1 to 20.Primary Contact Name First Last Contact Title*Contact Email* Enter Email Confirm Email Contact Phone*Total $0.00 Credit Card* Membership Terms I agree to the following terms: 1) The annual 6Beds vendor membership dues are $3,988 for Tier 1 and $1,488 for Tier 2, payable by credit card according to the selected payment frequency: quarterly, semi-annually, or annually. The annual membership fee for Independent Living Providers is $600. 2) I understand that I can cancel the membership on or after the anniversary date, but membership cannot be canceled before this date. Membership fees are non-refundable. 3) I acknowledge that automatic electronic payments to my account must comply with U.S. law, and I certify that I am an authorized user of this credit card account. I will not dispute the scheduled transactions with my credit card company, provided the transactions comply with the terms outlined in this authorization form. 6BEDS is a Mutual Benefit NON-PROFIT Corporation. Membership fees may be tax deductible (consult with your tax advisor) and are non-refundable.Vendor Member Signature*NumberNumber Δ