National Pozzolan Association: Membership Renewal Form

Renew NPA Membership

IDENTIFYING INFORMATION

Organization (or Individual) Name:

Complete the identification fields below if the information we have on file has changed in the last year.

Business Address:

City, State, Zip:

Phone:

Website:

PRIMARY POINT OF CONTACT

Designated Primary POC Name/Title:

Address (if different from above):

City, State, Zip:

Phone:

Email:

ALTERNATE POINT OF CONTACT

Designated Alternate POC Name/Title:

Address (if different from above:

City, State, Zip:

Phone:

Email:

MEMBERSHIP CLASSES & FEES

As necessary, update the membership category which best describes your NP involvment.

INDUSTRY MEMBERS

REGULAR MEMBERS: Natural Pozzolan (NP) production and sales in excess of 10,000 tons/year. Regular members have voting rights in the association. One vote per manufacturer or producer. ($5,000/year)

ASSOCIATE MEMBERS: Prospective producers of NP (or current producers with less than 10,000 tons/year production and sales of NP); Marketers or brokers of NP, Suppliers of equipment, materials, or services to the NP industry, and others in a related capacity. ($1,500/year)

SELECT CLASS

Membership renewal dues are calculated on a full year’s membership. Check the box related to the appropriate membership category as outlined above.

REGULAR MEMBER:
Production and sales in excess of 10,000 TPA - $5,000
ASSOCIATE MEMBER:
Prospective Producer or Producer under 10,000 TPA - $1,500
Supplier - $1,500
Marketer - $1,500

CERTIFICATION

Name/Title of Designated Representative Submitting Renewal:

Date of Renewal Submission:

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Use the PAY DUES button below to submit payment (via CC) for your membership renewal. You may also submit payment with a check to: Natural Pozzolan Association, 9980 S 300 W Suite 200, Sandy, UT 84070.

PAY DUES

NATURAL POZZOLAN ASSOCIATION

9980 S 300 W, Suite 200, Sandy, UT 84070 • 385-315-2402 • info@pozzolan.org

IMPROVING CONCRETE DURABILITY

NPA Membership Renewal Form

Renew NPA Membership

IDENTIFYING INFORMATION

MEMBERSHIP CLASSES & FEES

CERTIFICATION

Thank You. Your membership renewal has been submitted. Please submit payment above.

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