RadTech International North America
Please indicate the proper
membership category below
Name
CORPORATE SUPPLIER
Total annual revenue from sales of UV and/or EB
equipment, chemicals, services, etc. as described
below:
Title
Company
Major - annual RadTech support of $7,800
Annual revenue is excess of $10 million. Includes
four (4) individual memberships.
Address
Expanding - annual RadTech support of $4,100
Annual revenue between $5 million and $10 million.
Includes three (3) individual memberships.
City
State/Province
Zip/ Postal Code
Developing - annual RadTech support of $990
Annual revenue less than $1 million. Includes one (1)
individual membership from your company.
Country
Individual - annual RadTech support of $75
Company must already be a member in one of the
preceding categories.
Telephone
Email
Growing - annual RadTech support of $2,000
Annual revenue is excess of $1 milliion but less than $5
million. Includes two (2) individual memberships.
Fax
Signature
Date
If you are applying as a corporate member, attach a
list of individuals who should be included in the
membership, with name, title, address, telephone,
email address and fax numbers of each. Please
mail completed application along with a check (US
funds only) made payable to:
Rad Tech International North America
7758 Wisconsin Ave - Suite 302
Bethesda, MD 20814
(240) 497-1242 / (240) 209-2340 Fax
Or please provide your
Credit card information below:
Credit Card # ____________________________
Expiration Date # _________________________
Security Code # __________________________
Membership is renewed in September. Membership Dues are not refundable.
END USER
Company converts formulated products to final
form by the use of UV or EB technology and does
not produce or supply UV or EB curing equipment,
chemicals, services, etc.
Corporate - annual RadTech support of $1,050
Includes eight (8) memberships from your company.
Individual - annual RadTech support of $200
Individual membership for an employee of a company
that uses UV/EB technology. Company does not need
to be a member.
AFFILIATE
Individual member of academia, government
agencies or public utilities involved in UV and/or EB
technologies.
Individual - annual RadTech support of $85
Free - one year membership for qualified full time students*
*Must be approved by RadTech (North America students only)
My company is a supplier of:
My company is a user of:
____Raw materials
____Formulated
1
products.
____Process application curing equipment
____Support products and miscellaneous equipment
1
UV Technology (specify product produced)
1
EB Technology (specify product produced)
My job function is primarily: (Please Circle One)
1
1
1
Corporate Management
Manufacturing/Production
Research and Development
1
1
1
Marketing/Sales
Quality Control/Assurance
Health & Safety
1
1
1
Technical Services
Engineering
Consulting/Education
1
1
Government
Other (please specify
Market Segments In Which You Have Involvement - (Circle All That Apply)
1
Converting - silicone
Release liners, papers, films
1
Metal 3D spray
Golf clubs, plumbing fixtures, automotive, appliances.
1
Converting - coatings
Flexible packaging, solar film
1
1
Converting - flooring
Vinyl sheets and tiles, wood flooring
1
1
Converting - narrow
Labels, tags, flexible packaging, silicone release
1
Wood coating-profiles/flat sheet/3D
Molding, picture frames, particle board, MDF sheets,
doors, KD, case goods, chairs, general furniture.
Fiber, ribbon & cable
Optical fiber, coloring, multi-fiber ribbon, wire, wire
marking.
Non-auto glass coating & decorating
Bottles, tumblers, mirrors.
1
Web/Sheetfed offset
Aseptic packaging, cosmetic boxes, business forms,
direct mail, commercial printing, plastic sheet
printing.
1
Medical devices
Kits & trays, syringes, blood filters, body fluid bags,
catheters, etc.
1
Electronics
Component marking, encapsulation, conformal
coating of PCB, Photo resists.
1
Wide Web/Flexographic printing
Flexible packaging, snack foods, candy wrappers.
1
Automotive
Interior & exterior plastic parts, electronics, metal,
glass.
1
Consumer products-decoration & functional
Eyeglass lenses, pen bodies, tools, golf balls, trophies,
skis.
1
Plastic - functional coating, non-automotive & Cd’s
Construction materials, office furniture, industrial
lighting, snowmobiles, watercraft, Cd’s, CD-ROM”s,
DVD, reflectors.
1
Flat sheet screen printing and decorating
Advertising posters, signs, vehicle advertising, display
advertising.
1
Plastic container/decoration 3D spray
Cosmetic bottles, yogurt cups, toothpaste tubes.
1
Coil Coating
Steel Appliances, architectural products.
1
Metal pipe/Metal flat sheet decorative coatings
Fence posts, conduit, steel & alloy tubes, aerosol cans,
food cans, battery cases.
1
Adhesives
Laminating, pottings & PSA’s
Metal 2 piece cans, can ends
Beer and beverage containers
1
1
Other (specify)
1
None of the above
For Official Use Only
ID#
Check#
Date