Reference Form for Membership Applications

Applicant Company: *

1. How are you associated with this company? *

2. How long have been associated with this company? *

3. Have you physically visited the manufacturing site? *

4. Do they sell primarily to distributors or end users? *

5. What value do you believe this applicant will bring to NIBA? *

6. Other comments

Name: *

Company *

Email *

Phone *