NACE International Membership Application

New Renewal Change Would you like to receive information about corrosion-related products from other companies: h yes h no

PERSONAL & COMPANY DATA

Please complete both your office and home addresses. Where do you want information mailed? Office Home

First Name:

Last (Family) Name:

Company:

Business Address:

(Include mail stop)

City:

State/Province: Zip/Postal Code:

Country:

Business Phone: (Include area code for U.S. and country/city codes for international)

Business Fax: (Include area code for U.S. and country/city codes for international)

E-mail:

Web Address:

Home Address:

(Include mail stop)

City:

State/Province: Zip/Postal Code:

Country:

Home Phone: (Include area code for U.S. and country/city codes for international)

Have you been a member of NACE previously? Yes No If yes, NACE member #
PROFESSIONAL INTERESTS
A Sex: □ Male □ Female F My principal job function is: (Choose only one) 18 □ Coating & Lining Application
B Education level: 1 □ Management 19 □ Coating & Lining Manufacturer/Distributor
H □ High school diploma 2 □ Sales/Marketing 21 □ Plastics/Nonmetals
A □ Associate’s 3 □ Engineer 23 □ Measuring, Analyzing & Controlling
B □ Bachelor’s 4 □ Scientist/Researcher Instrumentation
M □ Master’s 5 □ Technician/Technologist 27 □ Railcar/Tank Trucks
D □ Doctoral 6 □ Professor/Teacher 50 □ Metals/Mining
P □ Post-doctoral 7 □ Student 51 □ Ships/Marine Structures/Offshore Platforms
O □ Other_______________________________ 8 □ Consultant 52 □ Oil & Gas Pipelines/Storage Tanks
(please describe) 9 □ Retired 53 □ Refining
10 □ Contractor 54 □ Power Plant/Electric Utility
C Have you earned a Professional Engineer’s license? 11 □ Inspector/QA/QC 55 □ Bridges & Highways
□ yes □ no 12 □ Chemist 56 □ Municipal Water Distribution/Treatment
D How did you hear about NACE? 13 □ Designer/Architect 57 □ Industrial Water Treatment
C □ Colleague 14 □ Maintenance 140 □ Other_______________________________
A □ Advertisement 15 □ Purchasing (please specify)
E □ Education Course 99 □ Other_______________________________ H Technologies I use in my job:
I □ Internet (please specify) 0 □ Cathodic/Anodic Protection
1 □ NACE Catalog G From the list below, choose the classification that best 1 □ Chemical Process
2 □ NACE Journal describes your company’s function. (Choose only one) 2 □ Coatings and Linings
0 □ Other_______________________________ 5 □ Engineering/Architecture/Consulting Firms 3 □ Inhibitors
(please specify) 6 □ Research Services 4 □ Materials Selection—Metals
7 □ Chemical Processing/Process Industries 5 □ Materials Selection—Nonmetals
E With regard to corrosion control products/services, I & Allied Products 6 □ Design
consider myself primarily a: 8 □ Aerospace 7 □ Testing & Monitoring
U □ User/Consumer 9 □ Pulp & Paper 8 □ Other_______________________________
S □ Supplier/Producer 11 □ Construction (please specify)
B □ Both 12 □ Testing Services
13 □ Oil & Gas Extraction I Birthdate ________ / ________ / ________
14 □ Original Equipment Manufacturer MM DD YY
OPTIONS OF MEMBERSHIP AND SERVICES AMOUNT TOTAL
1 YEAR 2 YEARS
Individual Membership $130 $250
Individual Membership with Corrosion journal $215 $420
$215 only includes access to the online journal • $235 includes both the printed and online journal $235 $450
Corporate Member
The person named on this application is the primary representative

h Platinum Corporate Member $5,000

h Gold Corporate Member $3,500
h Silver Corporate Member $1,500
h Bronze Corporate Member $1,000
h Nickel Corporate Member $500

For further information, please contact the NACE International Corporate Membership Specialist at:
Phone: +1 281-228-6271 • Fax: +1 281-228-6371
Online: www.nace.org/memberbenefits
Membership Certificate $15
Overseas Mail Option (available with paid subscription only—not valid in U.S, Canada, and Mexico)
Journals are sent via surface mail unless an airmail option is selected at an additional charge

h Materials Performance—12 issues $35 $70

h Corrosion journal—12 issues $35 $70
NACE Foundation Donation h $25 h $50 h $75 h $100 h Other $______ $______

NACE Foundation donations sustain the independent NACE Foundation. The NACE Foundation works with schools
and universities to advance corrosion education and support such activities as education outreach programs and
scholarships for deserving students. U.S. donations are tax-deductible to the full extent of the law. Contributions may
not be tax-deductible outside of the U.S.; therefore, review your local tax laws. For information, contact the NACE
Foundation at +1 281-228-6205 or visit www.nace-foundation.org.

Donation in honor/memory of: ___________________________________________________________

Add dues and options to calculate total amount to be paid. Amount paid

Membership dues are nontransferable and nonrefundable. Membership benefits are nontransferable.

PAYMENT OPTIONS
Payments can be made by check, money order, or credit card in U.S. funds made payable to NACE. $12 of membership dues (not deductible) is for a
Materials Performance subscription.
For faster processing, consider paying by credit card and faxing this form to NACE at +1 281-228-6329 or join online at www.nace.org.

h Check/money enclosed: U.S. $ Check number: Promo code:

h Credit card payment h MasterCard h VISA h American Express h Discover

Account number:

Expiration date:

Name as it appears on card:

Signature:

For more information, contact NACE FirstService at 1 800-797-6223 (U.S. & Canada) or +1 281-228-6223 (Outside the U.S. & Canada).

Mail completed application with payment to:

NACE International
PO Box 41027
Houston, TX 77241-1027
USA