International Packaged Ice Association
238 East Davis Blvd, Suite 213, Tampa, FL 33606
813/258-1690 800/742-0627; Fax: 813/251-2783
APPLICANT INFORMATION
Name of Firm: ______
Address of Home Office: ______
City: ______State/Province: ______
Country:______Zip/Postal Code: ______
Contact Name: ______Contact E-mail: ______
Telephone (Area Code): ______Fax: ______
Year Business Established: ______Number of plants: ______
Total Tonnage Capacity: ______Other Business engaged in: ______
Our Applicant fee of $450 is attached via check for payment for one year’s applicant status from the date of receipt.
OR
Please charge our Credit Card: AMX VISAMC
CC Number______Exp. ______CVV______
Name on Card______
Signed this ______day of ______, 2018
REFERRED BY:______
By: ______(Signature of executive in charge) (Print or type name of executive in charge)
Any individual, firm or corporation actively engaged in the production or distribution of ice for not less than one year shall be eligible to become an Applicant for Industry Membership in the Association.
Upon payment of the application fee, applicants shall receive a copy of the current PIQCS Manual and related materials, and shall have a Mentor appointed by the Association to serve as an advisor and to assist the applicant in meeting the requirements for Industry Membership. After payment of the application fee and prior to the applicant’s qualification for and acceptance into Industry Membership, the applicant shall be eligible for a one–time credit in an amount equal to the fee against the applicant’s registration fee at the Annual Convention or against the accepted applicant’s annual dues to the Association, whichever comes first. The applicant shall have one year from the application date to meet the requirements for Industry Membership as set forth above. After the expiration of one year from the initial application, an additional application fee shall be due if the applicant has not yet met the requirements for membership. Upon satisfactory completion of a PIQCS audit, receipt of certification and the payment of any unpaid dues balance at then prevailing Industry Member rates, applicants will be accepted into Industry Membership, commencing with notification from the Executive Director that all requirements have been met. Prior to the applicant’s acceptance into Industry Membership, the applicant shall not be eligible for the benefits of Industry Membership (including, e.g., listing in the annual membership directory and receipt of member communication pieces) and shall not be permitted to use the IPIA logo.