associate membership application form
ASSOCIATE MEMBERSHIP APPLICATION FORM The Ontario Waste Management Association (OWMA), founded in 1977, speaks for more than 250 members in the Private, Associate, Public and Affiliate sectors, who provide the products and services for a better environment. OWMA Associate members provide services, equipment, consulting and other relevant services to Private and Public OWMA members.
2017 ASSOCIATE MEMBERSHIP APPLICATION Company Name: _____________________________________________________________________________________________ Address: ___________________________________________________________________________________________________ City: ____________________________________________ Province: ____________________ Postal Code: ________________ Authorized Representative: ___________________________________________ Title: ___________________________________ Tel (
) ____________________________ Fax (
) ______________________ e-mail __________________________________
Website: _________________________________________ How did you learn about OWMA? ______________________________
............................................................................................... ASSOCIATE MEMBERS FEE
Membership fees are payable in Canadian Funds and are subject to HST
$1,100 (Please add 13% HST)
OPTION 1:
ATTACHED IS MY 2017 MEMBERSHIP FEE (CHEQUE OR CREDIT CARD VISA/MASTERCARD/AMEX)
OPTION 2:
PLEASE INVOICE ME FOR 2017 MEMBERSHIP FEES
........................................................................................................... PAYMENT OPTIONS: VISA
AMEX
MASTERCARD #: ______________________________________ EXPIRY DATE: _______________
CARDHOLDER NAME: _______________________________________ SIGNATURE: _____________________________________ HST REGISTRATION # 10400 2530
Please forward this application to: OWMA, 2005 Clark Blvd., Unit 3, Brampton, Ontario L6T 5P8 or by fax at (905) 791-9514
ASSOCIATE MEMBERS ANNUAL MEMBER AND SERVICES GUIDE INFORMATION PLEASE FILL OUT THE FOLLOWING INFORMATION TO BE INCLUDED IN OUR ANNUAL MEMBER AND SERVICES GUIDE AND ON OUR WEBSITE AT www.owma.org. PLEASE FILL OUT A SEPARATE SHEET FOR EACH LOCATION. Company Name: _____________________________________________________________________________________________ Address: ___________________________________________________________________________________________________ City: ____________________________________________ Province: ____________________ Postal Code: ________________ Tel
(
) ____________________________ Fax (
) ______________________ e-mail _________________________________
Website: _________________________________________ Authorized Representative Designated for OWMA Contact: The authorized representative is the official point of contact for the OWMA -- recipient of all mailings and information, voting representative for the company, and spokesperson for the company relative to OWMA issues. Name: ________________________________________________ Title: ____________________________________________ Email: _________________________________________________
Telephone: _____________________________________
You can add as many other people to the communications lists as you would like – these contacts will be listed under the company information on the website and in the Members and Services Guide and will receive mailings, email communications, newsletters etc.. Company Representative: _______________________________________________Title: ___________________________________ e-mail ____________________________________________
Phone: _____________________________
Company Representative: _______________________________________________Title: ___________________________________ e-mail ____________________________________________
Phone: _____________________________
Company Representative: _______________________________________________Title: ___________________________________ e-mail ____________________________________________
Phone: _____________________________
Other Industry / Trade Associations to which Company Belongs: ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________
..........................................................................................................
ASSOCIATE MEMBER SERVICE CATEGORIES: Please indicate which services your organization provides. __ __ __ __ __ __
Anaerobic Digestion Technologies Auctioneers (Equipment) Automation Equipment Bird/Vermin Control Building Systems CNG/NGV Vehicles/Filling Station Systems __ Collection Systems (Multi-Residential) __ Communication Systems __ Compactors __ Composting Technologies __ Consulting __ Air Quality/Odour __ CSA Guideline __ Environmental __ Government/Public Relations __ Planning (Land Use) __ Taxation __ Waste Auditing __ Containers (Waste & Recycling) __ Bags __ Bins __ Carts __ In Ground __ Conveyors __ Corrosion Control __ Crushers/Shredders __ Diesel Fueling Services __ Engineering __ Financing (Equipment/Vehicle)
__ GPS Tracking Systems __ Heavy Equipment (Off Road) __Compactors (Landfill) __ Excavators __ Front End Loaders __ Trucks/Earth Moving __ Insurance __ Instrumentation/Control Equipment __ Laboratory Testing __ Leasing/Rental __ Equipment __ Vehicles __ Lawyers/Legal __ Corporate __ Environmental __ Planning __ Monitoring Equipment __ Air Quality __ Engineering __ Environmental __ Odour Control Systems __ Pumps/Meters __ Recycling Equipment/Systems __ Complete Systems __ Balers __ Magnets __ Optical Sorters __ Screens __ RFID Systems __ Routing/GPS/Billing Software/Programs
__ Scales (Platform/Portable/Onboard) __ Tires __ Trailers __ Manufacturing __ Sales __ Service __ Training __ Vehicle Tarping Systems __ Vehicles (Chassis) __ Vehicles (Body) __ Front End __ Luggers __ Rear Loader __ Roll Off __ Side Loader __ Special Services __ Vacuum __ Vehicles (Equipment/Parts) __ Walking Floor Systems __ Wood Recycling Equipment __ Chippers __ Grinders __ Screens
PLEASE PROVIDE A BRIEF DESCRIPTION OF THE SERVICES AND/OR SUPPLIES YOU PROVIDE TO THE WASTE MANAGEMENT INDUSTRY. ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________
2017 ASSOCIATE MEMBERSHIP APPLICATION Company Name: _____________________________________________________________________________________________ Address: ___________________________________________________________________________________________________ City: ____________________________________________ Province: ____________________ Postal Code: ________________ Authorized Representative: ___________________________________________ Title: ___________________________________ Tel (
) ____________________________ Fax (
) ______________________ e-mail __________________________________
Website: _________________________________________ How did you learn about OWMA? ______________________________
............................................................................................... ASSOCIATE MEMBERS FEE
Membership fees are payable in Canadian Funds and are subject to HST
$1,100 (Please add 13% HST)
OPTION 1:
ATTACHED IS MY 2017 MEMBERSHIP FEE (CHEQUE OR CREDIT CARD VISA/MASTERCARD/AMEX)
OPTION 2:
PLEASE INVOICE ME FOR 2017 MEMBERSHIP FEES
........................................................................................................... PAYMENT OPTIONS: VISA
AMEX
MASTERCARD #: ______________________________________ EXPIRY DATE: _______________
CARDHOLDER NAME: _______________________________________ SIGNATURE: _____________________________________ HST REGISTRATION # 10400 2530
Please forward this application to: OWMA, 2005 Clark Blvd., Unit 3, Brampton, Ontario L6T 5P8 or by fax at (905) 791-9514
ASSOCIATE MEMBERS ANNUAL MEMBER AND SERVICES GUIDE INFORMATION PLEASE FILL OUT THE FOLLOWING INFORMATION TO BE INCLUDED IN OUR ANNUAL MEMBER AND SERVICES GUIDE AND ON OUR WEBSITE AT www.owma.org. PLEASE FILL OUT A SEPARATE SHEET FOR EACH LOCATION. Company Name: _____________________________________________________________________________________________ Address: ___________________________________________________________________________________________________ City: ____________________________________________ Province: ____________________ Postal Code: ________________ Tel
(
) ____________________________ Fax (
) ______________________ e-mail _________________________________
Website: _________________________________________ Authorized Representative Designated for OWMA Contact: The authorized representative is the official point of contact for the OWMA -- recipient of all mailings and information, voting representative for the company, and spokesperson for the company relative to OWMA issues. Name: ________________________________________________ Title: ____________________________________________ Email: _________________________________________________
Telephone: _____________________________________
You can add as many other people to the communications lists as you would like – these contacts will be listed under the company information on the website and in the Members and Services Guide and will receive mailings, email communications, newsletters etc.. Company Representative: _______________________________________________Title: ___________________________________ e-mail ____________________________________________
Phone: _____________________________
Company Representative: _______________________________________________Title: ___________________________________ e-mail ____________________________________________
Phone: _____________________________
Company Representative: _______________________________________________Title: ___________________________________ e-mail ____________________________________________
Phone: _____________________________
Other Industry / Trade Associations to which Company Belongs: ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________
..........................................................................................................
ASSOCIATE MEMBER SERVICE CATEGORIES: Please indicate which services your organization provides. __ __ __ __ __ __
Anaerobic Digestion Technologies Auctioneers (Equipment) Automation Equipment Bird/Vermin Control Building Systems CNG/NGV Vehicles/Filling Station Systems __ Collection Systems (Multi-Residential) __ Communication Systems __ Compactors __ Composting Technologies __ Consulting __ Air Quality/Odour __ CSA Guideline __ Environmental __ Government/Public Relations __ Planning (Land Use) __ Taxation __ Waste Auditing __ Containers (Waste & Recycling) __ Bags __ Bins __ Carts __ In Ground __ Conveyors __ Corrosion Control __ Crushers/Shredders __ Diesel Fueling Services __ Engineering __ Financing (Equipment/Vehicle)
__ GPS Tracking Systems __ Heavy Equipment (Off Road) __Compactors (Landfill) __ Excavators __ Front End Loaders __ Trucks/Earth Moving __ Insurance __ Instrumentation/Control Equipment __ Laboratory Testing __ Leasing/Rental __ Equipment __ Vehicles __ Lawyers/Legal __ Corporate __ Environmental __ Planning __ Monitoring Equipment __ Air Quality __ Engineering __ Environmental __ Odour Control Systems __ Pumps/Meters __ Recycling Equipment/Systems __ Complete Systems __ Balers __ Magnets __ Optical Sorters __ Screens __ RFID Systems __ Routing/GPS/Billing Software/Programs
__ Scales (Platform/Portable/Onboard) __ Tires __ Trailers __ Manufacturing __ Sales __ Service __ Training __ Vehicle Tarping Systems __ Vehicles (Chassis) __ Vehicles (Body) __ Front End __ Luggers __ Rear Loader __ Roll Off __ Side Loader __ Special Services __ Vacuum __ Vehicles (Equipment/Parts) __ Walking Floor Systems __ Wood Recycling Equipment __ Chippers __ Grinders __ Screens
PLEASE PROVIDE A BRIEF DESCRIPTION OF THE SERVICES AND/OR SUPPLIES YOU PROVIDE TO THE WASTE MANAGEMENT INDUSTRY. ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________ ___________________________________________________________________________________________________________
