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2012 Facility and Vendor Membership Application Please complete the following: Legal Facility (CON) Name: DBA Name: Address: City: State: Zip code: Telephone: Fax: Web Address: Facility Ownership
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Facility and vendor membership refers to the membership status of an organization or individual as a facility or vendor within a specific system or organization.
Any organization or individual who wishes to become a facility or vendor within a specific system or organization is required to file facility and vendor membership.
To fill out facility and vendor membership, you need to provide the required information about your organization or yourself, including contact details, services offered, and any relevant certifications or licenses.
The purpose of facility and vendor membership is to establish a formal relationship between the facility or vendor and the system or organization, enabling collaboration, access to resources, and participation in relevant activities.
The information that must be reported on facility and vendor membership includes organization or individual name, contact details, services or products offered, certifications or licenses, and any other relevant information requested by the system or organization.
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