Member Application Member Application Business Information Company Name: * Leave Blank: Phone: * Website: Email: * Business Description (200 char max): * Directory Category: --- Select Primary Category --- 07 Convention attendees 2008 Nat'l. Conv. Attende 2008 Nat'l.Conv.Attendee ARCHITECTS/ENGINEERS Association Execs Banks Caterers CHAPTER EXECS Employee ERAC Estimator Estimators Hotels/Clubs/Restaurants Hotels/Clubs/Restaurants' Indistry Night 09 Industry Fund Contributor Industry Nigfht Industry Night Industry Night - 2007 Industry Night 09 Industry Night 2006 Industry Night-2007 Investor Legal Manufacturer/Supplier (Non-member) Member-Affiliate Member-Associate Member-Association Member-Contractor Member-Retired Miscellaneous OSHA Personal Retired Seminar/Speakers SMACNA National SMWIA SMWIA Local 12 SMWIA Local No. 12 Speaker Supplier Suppliers Vendor Vendor (Promotional Gift) Vendor (Seminars) Vendor (Telephone Maint.) Vendor (Travel Zone Maps) Xmas candy recipients Employees: Full-time Part-time Comments / Questions: Physical Address Line 1: * Line 2: City: * State: * Postal Code: * Country: * --- Select Country --- Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo (DRC) Costa Rica Côte d’Ivoire Croatia Cuba Czechia Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Ghana Greece Greenland Guatemala Haiti Honduras Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Laos Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, FYRO Malaysia Maldives Mali Malta Mexico Moldova Monaco Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Singapore Slovakia Slovenia Somalia South Africa Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Türkiye Turkmenistan Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Venezuela Vietnam World Yemen Mailing Address Same as physical address Line 1: Line 2: City: State: Postal Code: Country: --- Select Country --- Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo (DRC) Costa Rica Côte d’Ivoire Croatia Cuba Czechia Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Ghana Greece Greenland Guatemala Haiti Honduras Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Laos Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, FYRO Malaysia Maldives Mali Malta Mexico Moldova Monaco Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Singapore Slovakia Slovenia Somalia South Africa Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Türkiye Turkmenistan Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Venezuela Vietnam World Yemen Primary Contact Information First Name: * Last Name: * Title: Phone: * Cell Phone: Fax: Email: * Contact Preference: Email Phone Address Same as Member Address Line 1: * Line 2 City: * State: * Postal Code: * Country: * --- Select Country --- Afghanistan Albania Algeria Argentina Armenia Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Belgium Belize Bermuda Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil British Virgin Islands Brunei Bulgaria Cambodia Cameroon Canada Caribbean Chile China Colombia Congo (DRC) Costa Rica Côte d’Ivoire Croatia Cuba Czechia Denmark Dominican Republic Ecuador Egypt El Salvador Eritrea Estonia Ethiopia Faroe Islands Finland France Georgia Germany Ghana Greece Greenland Guatemala Haiti Honduras Hong Kong SAR Hungary Iceland India Indonesia Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Korea Kuwait Kyrgyzstan Laos Latin America Latvia Liechtenstein Lithuania Luxembourg Macao SAR Macedonia, FYRO Malaysia Maldives Mali Malta Mexico Moldova Monaco Mongolia Montenegro Morocco Myanmar Nepal Netherlands New Zealand Nicaragua Nigeria Norway Oman Pakistan Panama Paraguay Peru Philippines Poland Portugal Puerto Rico Réunion Romania Russia Rwanda Saudi Arabia Senegal Serbia Singapore Slovakia Slovenia Somalia South Africa Spain Sri Lanka Sweden Switzerland Taiwan Tajikistan Thailand Trinidad and Tobago Tunisia Türkiye Turkmenistan Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Venezuela Vietnam World Yemen Billing Contact Information Same as Primary Contact First Name: * Last Name: * Title: Phone: * Cell Phone: Fax: Email: * Contact Preference: Email Phone Address Same as Member Address Line 1: * Line 2 City: * State: * Postal Code: * Country: * --- Select Country --- Canada United States Membership Options Payment Option: Bill me Please scroll down to view the entire policy and then click Accept. Decline I have read and accept the privacy policy of SMACNA of Western PA. I grant SMACNA of Western PA permission to contact me regarding my account, news, updates, and offers. Please read and accept the privacy policy before continuing. Print Application