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)

AFFILIATE MEMBERS: Affiliate members are organizations or individuals with the same goals as the Association, but are not eligible for membership as a Regular or Associate Member. Examples of Affiliate Members are engineering firms, environmental firms, law firms, end-users of NPs (i.e. ready-mix producers, highway pavers, cement and wallboard producers, block producers, precast producers, cementitious materials containing NP, etc.), universities, agricultural interests, and organizations or individuals that promote the use of NPs in green building and sustainable development, and general NP enthusiasts. ($500/$300 year depending on size–see below)

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
AFFILIATE MEMBER:
Large - 10 or more full time/contract employees: $500
Small - Up to 10 full time/contract employees: $300

CERTIFICATION

Name/Title of Designated Representative Submitting Renewal:

Date of Renewal Submission:

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Use the PAYMENT button below to submit payment (via CC) for your membership renewal. Select the appropriate membership class from the dropdown menu before clicking button. You may also submit payment with a check to: Natural Pozzolan Association, 100 East 155 South, Malad City, ID 83252.

NATURAL POZZOLAN ASSOCIATION

100 East 155 South, Malad City, ID 83252 • 208.252.2808 • 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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