Membership Application

Applications will be considered upon receipt of the initiation fee.

All fields must be completed for your application to be considered.

Date: / Referred by (name/company):

MEMBERSHIP CATEGORIES (Indicate the category that describes you/your organization)

Manufacturer Member: Companies whose primary business is manufacturing or adding direct, tangible value to the product (heat treaters, coaters, etc.)

Affiliate Member: Non-manufacturing companies whose business model is to serve exclusively manufacturers

Associate Member: Non-manufacturing companies whose business model is to serve multiple industries

Non-Profit Organization (Associate Member): Entities which are designated as non-profit by the IRS, including non-profit education institutions.

Senior Member: Retired individuals who have been employed by a DRMA member company during his or her career. Please list member employers:

COMPANY/ORGANIZATION INFORMATION

Company Name: / No. of Employees:
Local Street Address:
City/State/Zip: / County:
P.O. Box: / City/State/Zip:
Main Telephone: / Main Fax:
Website:

Describe your primary business (your primary capabilities, products, services, etc.):

Company/organization promotional statement(for DRMA website):

COMPANY CAPABILITIES/PRODUCTS/SERVICESthat you offer to your customers(check all that apply)

Manufacturer Members

Rev 6/22/2018Page 1 of 2

Assembler

Brazing

Casting/foundry

Coating

Dies

EDM

Grinding

Heat treating

Laser cutting

Manufacturer

Metal fabrication/welding

Molds

OEM

Plating

Precision machining

Special machine building

Tooling (jigs, fixtures, gages)

Other

Rev 6/22/2018Page 1 of 2

Affiliate and Associate Members

Rev 6/22/2018Page 1 of 2

Accounting

Banking

Business consulting/services

Construction

Crane/rigging

Education/training

Employee benefits

Engineering services

Equipment distributor

Facilities maintenance

Financial services/planning

Industrial supplies/services

Information technology

Insurance

Integrator

Legal services

Manufacturers’ rep

Media

Metal/raw material distributor

Personnel placement

Quality services/calibration

Real estate

Safety products/services

Sales/marketing

Software developer/sales

Other

Rev 6/22/2018Page 1 of 2

INDUSTRIES SERVED(Manufacturer Members only) (check all that apply)

Rev 6/22/2018Page 1 of 2

Aerospace

Appliances

Automotive/Transportation

Defense

Energy

Medical

Other

Rev 6/22/2018Page 1 of 2

CONTACT INFORMATION

Primary contact

Name:Title:

Phone:Email:

Secondary contact

Name: Title:

Phone:Email:

Top local company official

Name: Title:

Phone:Email:

Person to whom invoices should be sent

Name: Title:

Phone: Email:

MEMBERSHIP FEES

Initiation Fee(one-time fee; to be submitted with application)

ManufacturerMembers:$100

Affiliate Members:$200

Associate Members:$300 (includes non-profit organizations)

Senior Members:$25

Payment Method:

Check (make payable to DRMA) / Credit card (all major cards accepted)
Card #:
Exp. Date: / CVV Code: / Billing Zip Code:

Annual Dues: Dues will be invoicedupon application approval on a calendar year pro-rated basis. The next year’s dues are invoiced each December.

Dues (do not send with application)
Manufacturer / Affiliate / Associate / Non-Profit / Senior
# Employees* / $625 / $100
1-19** / $450** / $525** / $625
20-49 / $575 / $650 / $750
50-99 / $750 / $825 / $925
100-349 / $925 / $1000 / $1100
350-799 / $1225 / $1300 / $1400
800+ / $1550 / $1625 / $1725

*To calculate your number of employees: Count all employees in all your facilities located within a 75-mile radius of Dayton. (If your company is located outside the 75-mile radius: count all employees in your facilities from which your company benefits by being a member.)

**1-5 employees: Companies qualifying as a Manufacturer or Affiliate membership and who have 5 or fewer employees are provided a $150 discount on dues for two calendar years. After the second calendar year, the standard dues rate applies.

Rev 6/22/2018Page 1 of 2