NIBA -Distributor/Fabricator App (rev 3 24 2020)
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Contact Information


Lightweight Belting
Heavyweight Belting
Other (please specify below)

Mechanical Slitter
Lacing Equipment
High Frequency Presses
Vulcanizer (Heavy Weight & Light Weight)
Cleating/V-guide Machinery

Vulcanizing/Fabrication and Installation - Shop
Vulcanizing/Fabrication and Installation - Field
Firm Information

Other (please specify below)

Other Information


NIBA requires a minimum of 2 references for each application, but we encourage you to include more than 2. One reference must be from a NIBA member company. You may submit reference feedback using the online form found on our website or by uploading paper forms as part of your application.  Reference forms should be uploaded as PDFs or Word documents.

Submission of incomplete forms will result in a delayed review process.

Contact NIBA staff if you do not know of a NIBA member company.

20MB max

20MB max

20MB max
Directory Contacts and Branches

All individuals listed here will appear in the NIBA online and print directories. If an individual does NOT want their information published indicate below.

Name Title Email Do NOT publish information in NIBA directories.

All branches listed here will appear in NIBA online and print directories.

Branch Name Address City, State, Zip/Postal Code, Country Phone and Email
Terms and Conditions

Privacy Policy

The NIBA-The Belting Association respects the privacy of its members and other visitors to its web site. NIBA strongly believes that if electronic commerce and online activities are to flourish, consumers must be assured that information provided online is used responsibly and appropriately. To protect online privacy, NIBA has implemented the following policy.

What Information Does NIBA Collect?
Most data NIBA collects is used only to help us better serve our members. It is our general policy to collect and store only personal information that our members and visitors knowingly provide. If our privacy policies change, we will notify all users by e-mail or a special announcement placed on the web site.

From general visitors. NIBA does not collect any personal information from users browsing its web site. Only aggregate data — such as the number of hits per page — are collected. Aggregate data are only used for internal and marketing purposes and do not provide any personally identifying information.

From NIBA members, Convention registrants, and other customers. To gain access to members-only resources and personalization features on, members and other users are asked to register and provide some limited information. This information is submitted voluntarily. NIBA asks users to provide their name, member number (for members), organization name, business phone, and e-mail. Similar information may be submitted to NIBA through membership applications, conference or seminar registration, publication orders, subscriptions, and contest registrations. Additionally, for some e-mails sent in HTML format by NIBA to its members through its listservs and electronic newsletters, we will collect specific information regarding what the recipient does with that email. For those emails, NIBA will monitor whether a recipient subsequently clicks through to links provided in the message. Other information collected through this tracking feature includes: email address of a user, the date and time of the user's "click," a message number, name of the list from which the message was sent, tracking URL number and destination page. NIBA only uses this information to enhance its products and distribution of those products to its members. This information is not sold or distributed in any other manner.

How Does NIBA Use Data Collected?
NIBA uses information voluntarily submitted by members and other customers in the following ways:

NIBA Member Services and Products.
Generally, NIBA and its direct subsidiaries use data collected to improve its own web content; to respond to visitors' interests, needs and preferences; and to develop new products and services.

Disclosures to Third Parties. NIBA also makes member contact information available through the NIBA Membership Directory to other members using its web site and to those who register for its conferences. In addition, NIBA incorporates information users provide into hard copies of the Membership Directory that it provides to members. On occasion, NIBA may also provide limited data to third parties that offer products and services. These limited data include names, job titles, companies and business addresses, but do not include business phone numbers, business fax numbers or e-mail addresses.

Consent to Use Personal Information. For the purposes of the Data Protection Act(s) 1984 and 1998 (as applicable), NIBA or its agents must store, host and otherwise process the information (including personal data) supplied by the user when registering for this website. NIBA may send such data outside the European Economic Area for processing. If you reside in the European Union, please indicate your consent that the personal information you have provided may be transferred and stored in countries outside of the EU, including the United States. User supplies as defined above when registering for the website in order to allow NIBA (or its designated agents) to use the information to send the user unsolicited direct mail advertisements, promotions, and solicitations for third parties' products and services.

Credit Card Account Information. NIBA does not disclose credit card account information provided by its members and customers. When members and customers choose to pay using their credit cards, NIBA submits the information needed to obtain payment to the appropriate clearinghouse.

How Does NIBA Use Cookies?
Cookies are files that contain information created by a web server that can be stored on a User's hard disk for use either during a particular session ("per-session" cookie) or for future use ("persistent" cookie). NIBA uses cookies only to facilitate automated activity, store and track passwords, determine appropriate solicitations, and review navigation patterns. Cookies are not used to disseminate significant information about Users over the Internet or to analyze any information that Users have knowingly or unknowingly provided. When a user registers, the system will ask whether the user approves of the attachment of a cookie. Users may instruct their Internet browsers to opt out of accepting a "persistent" cookie and rather accept only a "per-session" cookie, but will need to login each time they visit the site to enjoy the full benefits. If the user declines the attachment of any cookie, the user may not have access to the full benefits of the website. Registration enables the site to better determine members' interest areas and provide the most relevant information.

What Privacy Issues Arise with Links To Other Sites?
This web site contains links to other web sites. NIBA has no control over and is not responsible for the privacy policies or content of such sites.

What Means Of Redress Are Available?
If any user suspects NIBA has handled its personal information in a manner that does not comply with this privacy statement, please contact us by e-mailing NIBA staff or by calling 608-310-7549.

Terms of Use


NIBA presents the information on this website as a service to our members and other Internet users. NIBA makes no warranty or guarantee concerning the accuracy or reliability of the content at this site or other sites to which we link. Any unauthorized downloading and distribution of any copyrighted material from this site or sites to which we link, without the copyright owner's permission, is strictly prohibited.

No Service Warranties
This website and the information, software and other material available on or accessible from this website is provided on an "as is" and "as available" basis without warranties of any kind, either express or implied, including but not limited to warranties of title, non-infringement or implied warranties of merchantability or fitness for a particular purpose. NIBA does not warrant that the web site service will be uninterrupted or error free or that any information, software or other material available on or accessible through the web site is free of viruses, worms, trojan horses or other harmful components.

Under no circumstances shall NIBA be liable for any direct, indirect, incidental, special, punitive or consequential damages that result in any way from your use of or inability to use the web site or your reliance on or use of information, services or merchandise provided on or accessible through the web site, or that result from mistakes, omissions, interruptions, deletion of files, errors, defects, delays in operation, or transmission, or any failure of performance.

You agree to defend, indemnify and hold NIBA harmless from any and all liabilities, costs and expenses, including reasonable attorney's fees, related to any violation of these terms and conditions by you.

Application Submission

I have carefully reviewed the Membership Eligibility Requirements approved by the Board of Directors for the Classification of Membership for which I am applying, and hereby certify that my company meets all these requirements without exception.

Upon acceptance of this application, our company agrees to abide by the bylaws and other regulations of NIBA. We understand that our membership will continue on an annual basis until a written resignation has been tendered and duly accepted.