ASNT Corporate Partner Application

Return this application with dues to:

Mail

The American Society for Nondestructive Testing

1711 Arlingate Lane
Columbus Ohio USA 43228-0518

Fax 614.274.6899
Online www.asnt.org

For Questions Contact:

Phone 614.274.6003

Toll Free 800.222.2768

(US/Canada)

Partner Information

Source Code =WEB

Company Name

Contact Name

Not a member unless designated as delegate

Address
City

State

Phone

Fax

Company Contact Email

Company Website

Corporate Partner Fee $410

Zip/Postal Code

Country

SIC/NAICS Code

Dues are nonrefundable and nontransferable.*

Corporate Partners are entitled to three (3) delegate members.

1
Last Name

First Name

M.I.

Mailing Address

City

State

Zip/Postal Code

Country

Home

Email

Former Member:

Business
Yes

No

Date of Birth (dd/mm/yyyy)

2
Last Name

First Name

M.I.

Mailing Address

City

State
Home

Zip/Postal Code

Country

Email

Former Member:

Business
Yes

No

Date of Birth (dd/mm/yyyy)

3
Last Name

First Name

M.I.

Mailing Address

City

State

Zip/Postal Code

Country

Home

Email

Former Member:

Business
Yes

No

Date of Birth (dd/mm/yyyy)

Complete both sides of this form and mail or fax to: ASNT, 1711 Arlingate Lane, Columbus, OH
USA 432280518 Fax 614.274.6899. You can also join online at www.asnt.org.
*Pricing valid until 30 June 2007

Company Name

Research in Nondestructive Evaluation (RNDE) Individual Subscription

RNDE is ASNTs quarterly research journal. Volume 17 (2006)
Print Subscription
Electronic Subscription
Both a savings of $35

$55
$55
$75
Pricing subject to change

Overseas Airmail Fee (Optional) company copy and per delegate member, per year

Materials Evaluation
RNDE Subscription

$58
$35

Unless airmail is specified, all materials will be sent sea/surface mail; allow 3-4 months for delivery.

Company Profile
How did you hear about ASNT Corporate Partner affiliation?
If sponsored, by whom?
How many people are involved with NDT
at your place of business?
15
2150
620
51+

With what nondestructive testing method do you work?

(check all that apply)
Acoustic Emission
Radiography
Electromagnetic/ET
Thermal/Infrared
Leak
Ultrasonics
Liquid Penetrant
Vibration Analysis
Magnetic Particle
Visual
Neutron Radiography

Type of business (check only one)

Commercial Lab
Manufacturing
Consultant
Research
Education
Sales
Government
Training
Equipment
Industry of focus at place of
Aerospace
Automotive
Chemical & Petroleum
Electronics
Marine
Materials Joining
Ferrous Materials
Nonferrous Materials
Nonmetallics
Nuclear

business (check all that apply)

Ordnance
Railroad
Utilities
Labs
Other___________________
NDT Services
Software
Medical
Optical
Robotics

Payment Information
Form of Payment

AmEx

Type of Card

Personal

With what applications of NDT do you work?

Calibration
Plant/operation maintenance
Design
Process Control
Failure Analysis
Production
Field Service
QA/QC Reliability
Incoming Inspection
Research
In-service
Other__________________

Total Amount Paid $

MasterCard

Discover

Check

Business

Account Number
Name on Card

Visa

Expiration Date

CIN*

Print please

Signature
Cardholder Information
Address, City, State, Zip, Country
*Credit Card Identification Number. For Visa/MasterCard/Discover: The three-digit value is printed on the signature panel on the back of cards immediately
following the account number. For American Express: 4 digit, non-embossed number printed above your account number on the face of your card.