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Membership Application


Please complete all of the following items that apply. * indicates a required field
Company Information:

Individual name:*
Company name:*
Headquarters address:*
City:*
State/Province:*
Zip/Postal Code:*
Country:*
Telephone:*
Fax:
Website:*
Is your Company:



Names and Locations of Plants:

Please list at least one manufacturing plant or Design/Engineer Facility in North America where you produce products that qualify your company for membership as described.*


Association Member Voting Representative:

This person is the most senior level contact between NEMA and the company. This person may also be the Section Voting Representative. Among other things, this person will receive communications from the NEMA Board of Governors, the NEMA president, and the president’s office, and will receive the NEMA dues billing. There is to be only one association member voting representative per company.

Name:*
Title:*
Address:*
City:*
State/Province:*
Zip/Postal Code:*
Country:*
Telephone:*
Fax:
Email:*

Section Voting Representative:

This position is for the individual who will participate at the section level and has voting rights for the company. This individual will be responsible for representing the company’s business interests in various NEMA forums. For each section affiliation, a member has one voting representative and that same individual may be the voting representative for multiple sections. If different individuals participate in different sections as a voting representative, please attach a separate sheet with name, contact information, and the section name.

Name:*
Title:*
Address:*
City:*
State/Province:*
Zip/Postal Code:*
Country:*
Telephone:*
Fax:
Email:*

Section Alternate Representative:

This position is for an individual who will participate at the section level and serve as the voting representative should the section level voting representative choose not to vote or otherwise be unavailable. For each section affiliation, the same individual may be the alternate representative for multiple sections.

Name:*
Title:*
Address:*
City:*
State/Province:*
Zip/Postal Code:*
Country:*
Telephone:*
Fax:
Email:*

Statistical Contact:

This position is for an individual responsible for reporting market data for an approved NEMA statistical program.

Name:
Title:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Telephone:
Fax:
Email:

MEMBERSHIP IN NEMA:

Please select a membership type:*



Signature of Corporate Officer authorizing this application:

I have read the Bylaws and I certify that this company meets the requirements for membership with NEMA. If this application is accepted and approved, then we agree to abide by the Certificate of Incorporation and bylaws of NEMA as they now exist and as they may be amended.

If you are a Corporate Officer, type, "I Agree" to digitially sign*

Otherwise, print out, sign, & fax to NEMA: (703) 841-3320

Signature:
Name(print):*
Title:*
Date:

Specify the product areas that your company manufactures:

Either type the sections/product areas in the field below
or check mark the sections/products that apply below.

Product Areas:

You may also select from the sections/products listed below:

BUILDING SYSTEMS

ELECTRONICS

INDUSTRIAL AUTOMATION

INSULATING MATERIALS

LIGHTING SYSTEMS

MEDICAL IMAGING

POWER EQUIPMENT

SECURITY IMAGING AND COMMUNICATIONS

WIRE AND CABLE


Click button to submit your NEMA Membership Application: