Application Inquiry for CHS Membership

Complete the Center for Hydrogen Safety member application inquiry form below and someone will be in touch with you about your inquiry.

Company/Organization Name & Address

Company/Organization Name *

Address Line 1 *

Street address, P.O. Box, company name, c/o

Address Line 2

Suite, unit, building, floor, etc.

City *

State/Province/Region *

Zip / Postal Code *

Country *

Lead CHS Representative

Name *

Title *

Office Number

Mobile Number

Email *

Additional Organizational Contacts

Provide additional names and email addresses of key people that you would like to receive the CHS Newsletter and Incident Notification Communications. You can also submit this information at a later date.

Is the financial contact for your organization different than the lead contact? *

Yes

Financial Contact

Name

Title

Address Line 1

Street address, P.O. Box, company name, c/o

Address Line 2

Suite, unit, building, floor, etc.

City

State/Province/Region

Zip/ Postal Code

Country

Office Number

Mobile Number

Company/Organization Information

What is your company’s/organization’s involvement in hydrogen (manufacturer, distributor, operator, etc.)? *

What is your company’s/organization’s future plans for hydrogen? *

What needs does your company/organization have that the Center for Hydrogen Safety can support? *

Does your company/organization have any specific safety questions or issues? *

Membership Type Requested

Membership Type *

Government Membership- $25,0000 /yr

Industry Membership- $15,000 /yr

Small Business/Startup Membership- $5,000 /yr

National Laboratory Membership- $5,000 /yr

University Membership- $2,000 /yr

Executive Board Membership- $50,000 /yr

Organization Logo

Please upload a high resolution file of your organization's logo, so we can feature it on our CHS Member webpage. You can also submit this file to us at a later date.
Files must be less than 2 MB.
Allowed file types: gif jpg jpeg png.

CHS Membership Statement

By applying for CHS Membership, your organization agrees to join a global community that supports and promotes the safe handling and use of hydrogen across industrial and consumer applications in the energy transition.

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