Print out this form, completely and send with payment to:
Print out this form, completely and send with payment to:
NATIONAL SOLID WASTES MANAGEMENT ASSOCIATION
4301 Connecticut Avenue, NW Suite 300, Washington, DC 20008 202-244-4700 FAX 202-966-4841
Dues: To determine dues, find your companies' gross annual revenues earned from services related to the management of waste in the prior calendar year. Several business interest activities are available to complement basic NSWMA services. Cost to participate is in additionto the annual NSWMA dues.
| Revenue in Millions | $ Annual Dues | Revenue in Millions | $ Annual Dues |
| <1 | $500 | 100 to <200 Million | $20,000 |
| 1 to <2 | $750 | 200 to <350 Million | $40,000 |
| 2 to <3 | $1,000 | 350 to <500 Million | $60,000 |
| 3 to <6 | $2,000 | 500 to <1 Billion | $100,000 |
| 6 to <10 | $3,000 | 1 to <1.5 Billion | $125,000 |
| 10 to <17 | $5,000 | 1.5 to <2 Billion | $150,000 |
| 17 to <23 | $7,500 | $25,000 increments for every $.5 Billion | |
| 23 to <50 | $10,000 | 8.5 Billion + | $500,000 |
| 50 to <100 Million | $15,000 | ||
Institutes: Institute Fees are waived for companies whose annual dues exceed $20,000.
$600 per company/per contact
Institutes are policy-making groups which develop positions on national issues. They are open to any member of NSWMA. Participants share information and ideas with other members through meetings; receive information packages on federal legislation, regulations and new technologies; develop and take positions on federal policies; and, as necessary, seek federal actions affecting their business interests.
Landfill Institute: Open to members with interests in landfilling issues for non-hazardous solid wastes. Participation includes a subscription to Landfill Update.
_____________________________________________________________________________________________
Company Contact Address City/St/ZIP PH/Fax
Medical Waste Institute: Open to members with interests in transporting, treating and disposing of medical waste and manufacturing products used to manage such wastes. Participation includes a subscription to MWI Update.
_____________________________________________________________________________________________
Company Contact Address City/St/ZIP PH/Fax
Institute Information Packages: $400 each package $1,250 for all four Information packages
Prepared up to 12 times per year may be purchased by those members interested in staying current about developments in various business segments but not interested in participating in Institute activities.
Landfill Update: Addresses matters related to non-hazardous solid waste landfills.
_____________________________________________________________________________________________
Company Contact Address City/St/ZIP PH/Fax
MWI Update: Addresses matters related to management of medical waste.
_____________________________________________________________________________________________
Company Contact Address City/St/ZIP PH/Fax
Professional Services Update: Addresses matters related to all forms of solid and hazardous waste management, including the impact of a broad array of environmental legislation and regulations.
_____________________________________________________________________________________________
Company Contact Address City/St/ZIP PH/Fax
Councils: Councils are non-policy making groups of individuals whose sole purpose is networking with peers and participating in educational forums. They are open to members of NSWMA.
Chairman's Council: Open to top-level executives from private member companies that collect, transport, store, treate, recycle, or dispose of waste. Members participate in an annual bus tour of facilities.
$1,000 (Initial payment towards tour costs.
____________________________________________________________________________________________
Company Contact Address City/St/ZIP PH/Fax
Membership Information Operations: Please check all of your company operations
| 1. Hauling - MSW | 7. Recycling MRF | 14. Compost Facility | |||
| 1A. Hauling - C & D | 8. Transfer Station | 15. Site Cleanup, Restoration | |||
| 2. Landfill MSW | 9. Waste Broker | 16. Cleaning - Tanks, Sites, Pipelines | |||
| 3. Landfill C & D | 10. Consulting Technical | 17. Closures - Tanks, Sites | |||
| 4. Medical Waste | 11. Consulting Legal | 18. Spill Response - Oil, Chemical | |||
| 5. Recycling End-User | 12. Consulting Financial | 19. Treatment - Biological, Chemical, Solidification | |||
| 6. Recycling Collection | 13. Consulting Other | 20. Handling - Liquids, Solids, Dioxins, Metals, PCBs |
Please circle the State(s) in which your company operates.
| Alaska, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Michigan, Minnesota, Missouri, Montana, Nebraska, North Dakota, Ohio, Oregon, South Dakota, Washington, Wisconsin, Wyoming | Connecticut, Delaware, Maine, Maryland, Massachusetts, New Hampshire, New Jersey, New York, Pennsylvania, Rhode Island, Vermont, Washington, D.C. | Alabama, Arizona, Arkansas, California, Colorado, Florida, Georgia, Hawaii, Louisiana, Mississippi, Nevada, New Mexico, North Carolina, Oklahoma, South Carolina, Tennessee, Texas, Utah, Virginia, West Virginia |
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Please contact your regional office below if you have any questions. |
||
| NSWMA - Midwest Region 1163 East Ogden Avenue Suite 705 - PMB 313 Naperville, IL 60563-8535 (800)NSWMA-MW (800)679-6269 Peggy Macenas |
NSWMA - Northeast Region 290 Turnpike Road PMB 407 Westboro, MA 01581-2843 (800)NSWMA-NE (800)679-6263 Steve Changaris |
NSWMA - Sunbelt Region 875 L'Ville-Suwanee Road Suite 310 - PMB 346 Lawrenceville, GA 30043 (770)513-1440 (888)679-6272 Mike Huff |
NATIONAL SOLID WASTES MANAGEMENT ASSOCIATION
4301 Connecticut Avenue, NW Suite 300, Washington, DC 20008 202-244-4700 FAX 202-966-4841
| Annual Dues: |
$_______________________ |
| Institute and Council Fees: |
$_______________________ |
| Institute Information Packages Fees: |
$_______________________ |
| Total Dues & Fees: |
$_______________________ |
Payment: Any change in ownership of a member company does not negate the obligation to pay full annual dues.
Make checks payable to NSWMA. Amount:$_____________________
Check # ___________ Credit Card (circle one): VISA MasterCard AMEX Expiration Date:____/____
____________________________________ ___________________________ ________________________________________
Name on Card Number Signature
We are aware that 14% of our total dues is non-deductible under code section 6033 and no part of our payment is a charitable contribution.
The undersigned company representative confirms that the information provided on this Declaration is accurate. Membership is on a calendar year - January through December. A member company is obligated to pay its full annual dues by the last day of February.
Company:____________________________________________Corporate Contact: _______________________________________
Address_______________________________________________ Title:________________________________________________
CITY/ST/ZIP_________________________________________________Phone_________________________________________
Web Address______________________________________________Fax:_____________________________________________
E-Mail_________________________________________
