1.Company Information:

Company Name

Division or Group (if applicable)

Street Address

Suite/Floor/Address 2

City

State/Province

Zip/Postal Code

Country

PO Box

Company Telephone

Website Address

2.Submitted by:

First Name

Last Name

Job Title

Telephone

Email

3.Referred by:

First Name

Last Name

Company Name

4.We have reviewed the NFPA membership types and definitions at www.nfpa.com and are applying for the following NFPA membership:

Manufacturer Membership

International Membership

Distributor Membership

Supplier Membership

Controls, IoT, and Data (CID)

Associate Supplier Membership

5.Company Description: Using descriptive rather than promotional terms, summarize the products and services your company provides or the type of business your company conducts. This description will be posted in the NFPA Membership Directory on the NFPA website.

6.Official Company Representative (OCR): The primary link between member company and NFPA. The OCR receives all governance ballots and association correspondence.

First and Last Name:

Job Title:

Phone:

Email:

7.Marketing Representative (MKT): Engages in NFPA's marketing and market information services, and receives market information reports.

First and Last Name:

Job Title:

Phone:

Email:

8.Primary Technical/Engineering Representative (TECH): Your company's point of contact for Technology Roadmapping activity and information, and Technical Standards developemnt.

First and Last Name:

Job Title:

Phone:

Email:

9.HumanResources/Workforce Contact: A person at your company who will engage with NFPA's workforce development programs. These programs are aimed at encouraging students at various educational levels to learn about fluid power and consider careers with NFPA member companies.

First and Last Name:

Job Title:

Phone:

Email: