National Pozzolan Association: Online Membership Application

Membership Application

Please complete the form and submit it for review. Upon application approval, go to SECTION 6 to make the membership payment and complete the process.

SECTION 1: APPLICANT INFORMATION

Applying Organization (or Individual) Name:

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:

SECTION 2: MEMBERSHIP CLASSES & DUES

Please read the following membership category descriptions to determine on 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 dues are calculated on a full year's membership. Check the membership dues 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

SECTION 3: NP RELATED INTEREST AND/OR INVOLVEMENT

Provide a descriptive profile of applicant's NP related business interests and activities. THIS SECTION MUST BE COMPLETED TO PROCESS THE APPLICATION.

SECTION 4: NP COMMITTEE INVOLVEMENT

Check one or more boxes to indicate your interest in serving on any of the following NPA program committees.

Membership/Events Committee
Government Affairs Committee
Sustainability/Green Initiatives/LEEDS Committee
Specifications/Standards
R&D/Testing Committee

SECTION 5: CERTIFICATION

Name/Title of Designated Representative Submitting this Application:

Date of Application Submission:

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SECTION 6: PAYMENT

Upon acceptance of application, please use the PAY DUES button below to submit payment (via CC) for your membership dues. 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 Form

Membership Application

SECTION 1: APPLICANT INFORMATION

SECTION 2: MEMBERSHIP CLASSES & DUES

SECTION 3: NP RELATED INTEREST AND/OR INVOLVEMENT

SECTION 4: NP COMMITTEE INVOLVEMENT

SECTION 5: CERTIFICATION

SECTION 6: PAYMENT

Thank You! Your application has been submitted. Please SUBMIT PAYMENT above.

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