Membership Application

PORCELAIN ENAMEL INSTITUTE
P. O. Box 920220, Norcross, GA 30010
Phone: 770-676-9366 — Fax: 770-409-7280

Name of Company:

Address :

City/State/Zip:

Phone:

Fax:

Company Representative(name, title):

Alternative Representative/Maximum of 3 (name, title):

We are applying for________________________________(Associate or Active) membership in the Porcelain Enamel Institute. Please use the Membership Dues Schedule to determine which section is applicable to your company.

Describe type of products manufactured, or type of equipment, supplies or products supplied by you which are used in the manufacture of porcelain enamel products. (You may send copies of literature.)

I understand that new member applications are subject to the Executive Committee's approval.



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