Associate (Supplier) Membership Application

Please use the application below to apply for VMA membership in the Supplier Category. To help expedite your application, please make sure you've reviewed the membership requirements and yearly dues. You will be contacted shortly after your application is received. Thank you for your interest in VMA!

Member Type *Type of Membership
First Name *First Name	Last Name *Last Name
Email Address *Your email address
Job Title *Job Title
Company Name *Company Name
Address Line 1 *Address Line 1
Address Line 2Address Line 2
City *City	State *
Zip Code *Zip Code	Country *Country
Phone Area Code *Area Code	Phone *Phone
Fax Area Code *Fax Area Code	Fax # *
Web Address *
CEO/President *Chief Operations Officer
CEO/President Email *
CFO NameChief Financial Officer
CFO Email
Statistical Contact
Statistical Contact Email
Education & Training Contact
Education & Training Email
Human Resources ManagerThe person most likely to post job openings in the VMA Career Center.
HR Manager Email
Editorial/PR Contact
Editorial/PR Email
Marketing/Sales Manager *Marketing/Sales Manager, contact for Advertising
Mktg/Sales Mgr Email *
Sales Contact #1
Sales Contact #1 Email
Sales Contact # 2
Sales Contact #2 Email
Sales Contact #3
Sales Contact #3 Email
Year Company Founded *Year Company Founded
Incorporated Where *Incorporated Where
Subsidiary or Div. 1 if anySubsidiary or Division 1
Location 1Location 1
Type of Operation 1
Subsidiary or Div. 2 if any
Location 2Location
Type of Operation 2Type of Operation 2
Total U.S. & Canada employment *Total employment in U.S. and Canada	Overseas OperationsOverseas Operations	Yes No
% of Company VolumePercent of Total Company Volume by Overseas Manufacturing Operations
Parent CompanyParent Company
Subsidiaries in IndustrySubsidiaries (other than applicant) in Flow Control Industry
V/A/C End-User Market/sValve, Actuator and Controls End-User Market/s
V/A/C Manufactured *Valves, Actuators and Controls Manufactured
Other Products Manufactured *Other Products Manufactured
Other Products End-User MarketOther Products End-User Market/s
Domestic Sales$ of Valves *Domestic Valve Sales $	Domestic Sales$ V/A/Cs *Domestic Sales$ of Valves, Actuators and Components
Domestic Sales-Other Products *Domestic Sales of Other Products$	TOTAL Domestic Sales$ *Total Domestic Sales$ of Valves, Actuators, Components and Other Products

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