SRMA Manufacturer Annual Membership
Welcome to Our Manufacturing Association! As part of our commitment to supporting your growth and success, we kindly ask you to fill out this brief registration form questionnaire. Your responses will help us understand your needs and tailor our services to better assist you.
Company Name
*
Years In Business
*
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 Name
*
First Name
Last Name
Primary Member's Title/Role
*
Primary Member's E-mail Address
*
Phone Number
*
Number of Employees
*
Annual Revenue
Manufacturing Industry Sector
Please Select
Construction
Contract
Machinists/Fabricators
Marine
Medical
Packaging Equipment & Supply
Print/Signage
Retail Products
Specialty Products
Other
NAICS code:
Preferably a manufacturing NAICS code
DUNS Number:
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.
Cancel
of
Company Website
*
Please enter the website where you would like the hotlink from your logo to send the user.
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 are your main products/services?
*
Is there anything else you want to get out of your SRMA membership?
Which services offered by SRMA and the FloridaMakes Network are you most interested in? (Select all that apply)
*
Business growth and strategic planning
Workforce development and training programs
Operational excellence and continuous improvement resources
Technology adoption and innovation resources
Export assistance and market diversification
Networking events and peer-to-peer learning opportunities
Advocacy and representation
Other
Are you willing to serve on an SRMA Committee?
*
Membership
Workforce Development
Event
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
Annual Membership Dues
Premier Membership - $1,495.00
Elite Membership - $895.00
Standard Membership - $495.00
Basic Membership - $195.00
Pay by Credit Card Here:
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Manufacturers Annual Dues:
$
1,495.00
Choose Level
Membership Option
Premier Membership
Elite Membership
Standard Membership
Basic Membership
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Total
$
0.00
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Info on each membership level can be found here:
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