Become a 6Beds Affiliate Vendor Affiliate Vendor Membership Individual/Business Name* Business Email Address* Phone Number*Fax NumberWebsite Business 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* Primary Contact Name First Last Contact Title* Contact Email* Enter Email Confirm Email Contact Phone*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) Credit Card* American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Month010203040506070809101112 Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Expiration Date Security Code Cardholder Name Membership Terms I agree to the following terms: 1) 6Beds membership dues is $3,988 for Tier 1 and $1,488 for Tier 2 annually, payable by credit card and the member’s chosen payment frequency of quarterly semi-annually or annually. 2) I understand that I can cancel the membership on or after the anniversary date. 3) Membership cannot be cancelled prior to the anniversary date. I acknowledge that the origination of automatic electronic payment to my account must comply with the provisions of U.S. law. I certify that I am an authorized user of this credit card account and will not dispute the scheduled transactions with my credit card company; so long as the transactions correspond to the terms indicated 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* Δ