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Application for Membership

Download printable membership application or fill out form below to submit electronically.

Your Company Information
   
Company Name
(Full corporate or business name)
Street Address
City
State Zip Code
Mailing Address
City
State Zip Code
Contact Name
Email
Cell Phone
Website
Main Office Telephone Fax
Toll Free Number
   
Receive Text Messages? Receive Email Newsletter?
   
  Signify the type of fastener operation that best describes your business. Although
you may cross over into more than one description, please select only the one
that best describes your operation in the capacity you desire to represent
yourself to the SFA membership.
Type of Fastener Business
   
Description of Business
Type of Organization  
Name and Home Office of Parent Organization
 
Names, Title and Address of Each Owner, Partner, Officer, Director or Shareholder Holding or Owning a Beneficial Interest of 5% or Greater, if not a Public Corporation
Name Title Address
   
Names, Title and Address of Any Other Key Management Personnel or Applicant Representative, if not Included Above
Name Title Address
   
Names and Locations of Branches and/or Subsidiaries
   
Date Applicant Company Was Incorporated or Commercial Business Began
Number of Years Under Present Ownership or Control
Name of Voting Representative
(May be changed at any time, in writing, to the Executive Director of the SFA)
Number of Employees
How many square feet in your facility ?
Is Your Fastener Inventory Over $50,000.00?
 
Have any of this applicant’s owners, principals, officers, directors or shareholders (5% or greater), while acting for, or on behalf of, this applicant, been convicted  in a criminal or held liable in a civil action of willful or reported disparagement of the business reputation, trade name, or product or a competitor?
 
Has any owner, officer, director, principal shareholder or key management personnel of the applicant:
  Been convicted of a felony, or of a misdemeanor or moral turpitude?
  Been convicted or held liable in either a criminal or civil violation of federal or state anti-trust statutes?

The above information is being submitted as support of our application for membership in the SFA. It is understood that this information will be held in confidence by the Association and its Board of Directors. I understand that any misrepresentation of facts may be considered grounds for revocation of membership.

You will be charged $300.00 for a one time initiation fee, which is refundable if not approved by the SFA Board of Directors. Billing of yearly dues of $350.00 will begin when your application is approved.

Signature of Applicant's Authorized Agent or Representative
Title
Date
   

Profile Image (can be your logo, office photo or personal business photo - jpg files only, image must be smaller than 2MB)
 
Enter Your Payment Information Below
First Name:
Last Name:
Card Type:
Card Number:  (without spaces)
Expiration Date:

Card Verification Number: (3 digit code on back of card)

Billing Address
Address 1:
Address 2:   (optional)
City:
State:
Zip Code:  (5 or 9 digits)

Total:

$300.00 USD



Southwest Fastener Association Logo
©2017 Southwestern Fastener Association
292 Sugarberry Circle
Houston, Texas 77024
Phone: 713-952-5472
Fax: 713-952-7488
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