Distributor Membership Application

Distributor Membership Application

Thank you for your interest in distributor membership with the Power Transmission Distributors Association. To be considered for membership, please complete the below application. If you need assistance with this process, or have any questions, please contact us at ptda@ptda.org or +1.312.516.2100.
Step 1.

Verify your company meets the requirements for PTDA Distributor Membership.
A firm, corporation or partnership whose business is involved in the stocking and distribution of power transmission and/or motion control products to Original Equipment Manufacturers and/or end-user markets and which provides value added services to its customers.

The business entity must:

(a)    Stock and distribute products from one or more of the following categories: adjustable/variable speed drives, bearings, belt and chain drives, clutches and brakes, motor/motion control products, conveyors & material handling components, shaft couplings & u-joints, hydraulics & pneumatics, gearing, linear motion, industrial specialty chemicals, motors, and pumps.

(b)   Be an authorized stocking distributor for at least one manufacturer of power transmission/motion control products who is a current member of the Association.

(c)    Meet such other such uniform criteria as established by the Board of Directors.
Step 2.

Tell us about your company.
Firm Name
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip CodeCountry
Company Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Company Email Address
example@example.com
Website
LinkedIn URL
According to PTDA bylaws, each Distributor Member firm shall name one person in its employ as the Designated Firm Representative who is active in the day-to-day management of the firm, not an employee of a separate division, affiliate, or sister company of the member firm. This Designated Firm Representative will represent the member firm, will have voting rights in the Association and can serve on the Board of Directors.
Firm Representative

First NameLast Name
Title
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip CodeCountry
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com
*By selecting this, you grant PTDA permission to for us to communicate with you regarding programs and services and other essential information and to allow PTDA to share your information in the very specific ways noted in our Privacy Policy.
Name/Address of your parent corporation (if different from the address listed above)
Our company distribution company sells to:
Your company must provide value-added services to your OEM and/or end-user customers to meet the requirements for PTDA members. Please describe the value-added (beyond having inventory in stock) your company provides.
Examples of value-added services:
How many total employees does your company have?
Why are you considering membership in PTDA?
How did you learn about PTDA?
PTDA was recommended to our firm by:

First NameLast Name

Step 3.

Tell us about your manufacturing partners.
PTDA bylaws require that the applicant must be an authorized stocking distributor for at least one manufacturer of power transmission/motion control products (PT/MC) who is a current member of the association (ptda.org/MemberList).

Please list three of your key manufacturers, one of which must be a current PTDA member.
Company #1
Contact

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Company #2
Contact

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Company #3
Contact

First NameLast Name
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.

Step 4.

Tell us about the products you distribute.
Select all applicable products categories:
Other PT/motion control products you distribute:

Step 5.

Provide us with one additional employee in your company to receive communications from PTDA and be included with your company’s listing.
A PTDA membership is a company membership—once approved, all of your employees can take advantage of the resources offered to members via the PTDA website. Upon approval, you will receive information on how your employees can create their own user name and password to access valuable members-only content on the PTDA website at www.ptda.org.

Please provide information for one employee who will serve as a secondary contact.
Name

First NameLast Name
Title
Address

Street Address

Street Address Line 2
CityState / ProvincePostal / Zip CodeCountry
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email Address
example@example.com

Step 6.

Determine your membership dues investment.
Your membership investment is based on your company’s annual sales of power transmission/motion control (PT/MC) products. Please indicate below your sales volume category. All values are in U.S. dollars.

Note: No payment is due now; you will be invoiced for your membership investment upon approval of your application. Membership Dues Investments may be deductible as an ordinary business expense under U.S. federal tax law, but not as a charitable deduction. All sales volume information herein supplied will be kept completely confidential.
PT/MC Sales Volume category
Name

First NameLast Name
Signature
Date

MonthDayYear
Date
Should be Empty:

Distributor Membership Application

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