Forms-Membership

• Create a profile

  • Is your organization a member of EBRC? To get involved, create a profile by completing the information below.

  • Affiliation*
    Don't see your organization? Learn how to get involved.
    Please selectAclidAgilentAsimovBASFCorteva AgriscienceDoDDHSDSMEBRCGenoFABHitachiInscriptaLanzaTechLululemonMITRENISTNSFOctantSynthegoTeselagenTierra BiosciencesTwistVTTZymergen
  • Work Email Address*
  • Is your email address associated with a Google Account?
    EBRC regularly uses the Google platform for document and file sharing.
    • Yes
    • No
    • I don't know.

  • Profile Information

    The following information will be used to create your EBRC Profile/Member Directory Listing.
  • First Name*
    As used in publications, will be displayed on site.
  • Last Name*
  • If different: Name you prefer to be called
    As you use on a name badge
  • Professional Title*
  • Primary Department
    Please enter as "Department of...."
  • Phone*
    Include area code, and country code if outside the U.S.
  • Phone Type*
    • Office
    • Cell
    • Home
  • Short Bio
  • Professional Portrait
    For best results, upload a square image minimum 600x600 pixels. Otherwise, photo will be automatically cropped and resized.
    Accepted file types: jpg, jpeg, png, gif.

  • Areas of Interest

    These questions are for our Membership Committee and/or Internal-Use only.
  • If you are interested in getting involved with an EBRC Working Group, please indicate your interest below.
    Select all that apply.
    • Policy & International Engagement
    • Security
    • Roadmapping
    • Education

  • Demographics

    EBRC collects demographic information to better understand the diversity of nominees and members. All questions are optional and play no role in membership decisions.
  • Gender self-identification
    Please selectMaleFemaleNon-binary / third genderPrefer not to say
  • Which category best describes your race?
    For definitions of the following categories, please see: https://www.opm.gov/forms/pdf_fill/sf181.pdf
    • American Indian/Alaska Native
    • Asian
    • Black or African American
    • Native Hawaiian/Other Pacific Islander
    • White
    • Decline to specify
    • Unknown/unavailable
  • Which category best describes your ethnicity?
    For definitions, please see: https://www.opm.gov/forms/pdf_fill/sf181.pdf
    Please selectHispanic or LatinoNot Hispanic or Latino
  • Comments
    This field is for validation purposes and should be left unchanged.