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ITSA Membership Information Request

Application for Membership

	Thermal Spray Contractor
	Academic Institution
	Thermal Spray Equipment/Consumables Supplier
	Other:

	Organization Name
	Street Address
	Street Address 2
	City
	State/Province
	Zip/Postal Code
	Country
	Phone
	FAX
	E-mail
	Web Site

Key Personnel and Titles:
	Name:
	Title:
	Name:
	Title:
	Name:
	Title:
	Name:
	Title:

Who will be the principal contact for International Thermal Spray Association correspondence?
	Name
	Title
	E-mail Address

	Year organization was established:

	Number of employees or organization members:

Sales per year:
	Less then $1,000,000
	$1,000,000 to $5,000,000
	$5,000,000 to $10,000,000
	More then $10,000,000

Are there branches or subsidiaries of you organization
	Yes
	No
	If "Yes," please list below


Type of Equipment Owned:
	Plasma
	HVOF
	Oxy/Fuel Powder
	Oxy/Fuel Wire
	Rokide
	Arc Wire
	Other


What percentage of your activity is thermal spray related?


How many salesmen (or organization members) do you have promoting thermal spray?

	International Thermal Spray Association - Headquarters Office - 208 Third Street - Fairport Harbor, Ohio 44077 USA Voice: 440.357.5400 - Fax: 440.357.5430 - Email: kathydusa@thermalspray.org