Section title: Forms

Membership Application

To apply for an X12 membership, complete and submit the following application form. The application will be reviewed and verified, then you will be notified of the next steps. You will receive a response within three business days of submission. If you have any questions, email info@x12.org.

Fields marked with an asterisk (*) are required


Individuals meeting the requirements for Individual Membership (see below), enter their name and mailing address below. All other applicants enter their organization’s legal name and mailing address below.


Member State
Member Country
The drop down list below displays the X12 membership categories and associated annual dues.

Each member is represented by a Primary Representative. The Primary Representative will receive all official communications from X12 including membership notices and ballots. The Primary Representative is the Member’s Designee and speaks for the member in all X12 matters. Submission of contact information below constitutes authorization to send official X12 communications. X12 does not sell or otherwise distribute contact information to external organizations.




Primary Representative State
Primary Representative Country
The Alternate Representative speaks for the member when the Primary Representative is not available. Individual memberships are not permitted to have Alternate Representatives. All other members may elect to name an Alternate Representative.Submission of contact information below constitutes authorization to send official X12 communications. X12 does not sell or otherwise distribute contact information to external organizations.



Alternate Representative State
Alternate Representative Country

The X12 Billing Contact is typically your Accounts Payable Department Contact or generic email address. The X12 Billing Contact will be copied on all membership renewal notifications and dues payment receipts.


X12 includes a number of specifically focused subcommittees. Use the boxes below to indicate an intention to participate in a committee’s collaborations.

  • X12C - Communcations and Controls
  • X12F - Finance
  • X12I - Transportation
  • X12J - Technical Assessment
  • X12M - Supply Chain
  • X12N - Insurance
  • B2X - Business to Everything
  • Select None if if do not plan to participate in standards development.
Subcommittee(s)

Enter your Standard Industrial Classification.

For statistical purposes, each applicant must self-select a classification. The drop down list below displays the classifications. Hovering over a classification in the drop down list displays the associated definition. Select the classification that best describes the member applicant.