AHTD Strategic Business Partner Program Application

AHTD Strategic Business Partner Program Application

$6,000 annual fee. Do not submit payment for the fee with application.

You will be invoiced when notified of approval.

Date

Company Name*

Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry

Phone Number*

Area CodePhone Number

Website*

Email*

example@example.com

Name of Individual Completing Application*

First NameLast Name

Title*

Please enter your job title.

How many years has your company been in business?*

Describe the strategic product or service your company can provide to AHTD member companies.*

Indicate the company that referred you to AHTD. If you were referred by a particular person within the company, include that person's name. Designate only one individual per company.

	Type in the open rows below.
Company
Individual Name
City/State
Title

Eligibility Requirements

Applicant must provide a business product or solution that is strategically related to the industrialautomation industry.
Applicant must provide a service/product that is in the best interests of AHTD and its members.
Applicant must not qualify for AHTD membership under criteria of Automation Solutions Provider (ASP) or asa Manufacturer.
Applicant must meet these qualifications and such other criteria as established by the Board of Directors.
Participants will not engage in “spamming” the AHTD membership. Any evidence of such a practice willautomatically disqualify the company from participating in the program resulting in fees and benefits beingimmediately forfeited.
There is no exclusivity of product or service for companies who apply to this program.
Strategic Business Partners cannot serve on the Board of Directors and are not eligible to vote or serve on committees.
Strategic Business Partners may register for AHTD semi-annual conferences, if there is interest in attending,at the usual nonmember rate.

The following section must be completed in order to be considered for membership in AHTD:*

I certify that all of the information submitted within this application is correct and in order. Additionally, I confirm that the company and individual described above (and any individuals from this company) will adhere to the qualifications/terms outlined above. I acknowledge that to become a Strategic Business Partner of AHTD, an applicant must fulfill the Strategic Business Partner Eligibility Requirements. Failure to follow the terms will be cause for automatic dismissal from the program resulting in fees and benefits being immediately forfeited.

Signature*

Use your mouse to draw your signature.

AHTD: N19W24350 Riverwood Drive, Waukesha, WI 53188

262.696.3645 | ahtd@ahtd.org | www.ahtd.org