SSPC TECHNICAL COMMITTEE MEMBERSHIP APPLICATION


Please complete the form below. Only one voting representative per company is permitted on any committee. Committee membership may be restricted in order to maintain a balance between suppliers and users/general interest members of a committee. Members of SSPC Technical Committees are required 1) to be Individual Members of SSPC in good standing and 2) to respond by the requested deadline to mailings from committees of which they are members. A committee member who fails to respond to more than three consecutive committee mailings will be removed from the roster of that committee.

Please Print Name:_________________________________________________________________________

Title:_____________________________________________________________________________________

Company:_________________________________________________________________________________

Address:__________________________________________________________________________________

Phone:_______________________________________Fax:_________________________________________

E-Mail:___________________________________________________________________________________

SSPCID#:_________________________________________________________________________________

Relevant Experience/Expertise: Please describe any relevant technical/professional experience or expertise which you feel qualifies you to participate in the activities of any of the Unit committees listed below.

____________________________________________________________________________________________

_________________________________________________________________________________________________

_________________________________________________________________________________________________


List committees of interest to you below. Indicate if you wish to be considered for voting or informational membership.

 
Committee Number

Committee
Name

Voting Rep.

NonVoting Rep.
       
       
       
       

If accepted, I agree to serve on the committees indicated above.

Signature:____________________________________________________Date:__________________________

Return completed application by to: SSPC: Society for Protective Coatings, Attn: Aimée Beggs, 40 24th Street 6th Floor, Pittsburgh, PA 15221 or by fax to: 412-281-9993.