Manufacturer Annual Membership
Company Name
*
Primary Member's Name
*
First Name
Last Name
Primary Member's Title/Role
*
Address:
*
Street Address
Street Address Line 2
City
Please Select
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
Zip Code
County of Manufacturing Facility
*
Charlotte
Collier
Glades
Hendry
Lee
Other
Primary Member's E-mail Address
*
Phone Number
*
Number of Employees
*
Annual Revenue
NAICS code:
Preferably a manufacturing NAICS code
Do you participate in the DoD Supply Chain?
Yes
No
Unsure
Referred By:
Company Logo Upload
Browse Files
Members will have a hotlink to their website. Upload your logo here. Accepted file types: jpg, gif, png, pdf, ai, psd, Max. file size: 100 MB, Max. files: 2.
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of
Company Website
*
Please enter the website where you would like the hotlink from your logo to send the user.
Which category does your company belong to?
*
Please Select
Contract Manufacturers
Machinists/Fabricators
Marine
Medical
Print/Signage
Retail Products
Specialty Products
Other
CEO/President's Name
First Name
Last Name
CEO/President's Email Address
example@example.com
CFO/Accountant's Name
First Name
Last Name
CFO/Accountant's Email Address
example@example.com
Operations/ Production Mgr's Name
First Name
Last Name
Operations/ Production Mgr's Email Address
example@example.com
HR Directors's Name
First Name
Last Name
HR Director's Email Address
example@example.com
Sales/Marketing Director's Name
First Name
Last Name
Sales/Marketing Director's Email Address
example@example.com
What products do you manufacture?
*
What do you want to get out of your SRMA membership?
*
Are you willing to serve on an SRMA Committee?
*
Membership
Workforce Development
Community
Government Advocacy
None
How are you paying?
*
Receive formal invoice and I'll pay by Check, ACH or Credit Card
I'll pay by Credit Card directly from this form
Paying via Invoice, Select One:
First-year, Discounted Dues: $100.00
Manufacturers Annual Dues: $475.00
Paying by Invoice, Select One:
First-year, Discounted Dues: $100.00
Manufacturers Annual Dues: $475.00
Paying by Credit Card now, Select One:
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First-year, Discounted Dues:
$
100.00
Manufacturers Annual Dues:
$
475.00
Enter coupon
Apply
Total
$
0.00
Submit
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