NIBA 2022 Convention: Prospective Member App

Submit the information requested below to learn more and/or be considered for one of our prospective member opportunities. NIBA approval is required to qualify. We must receive this information as soon as possible to allow enough time for follow up.

Fields marked with an * are required.

Organization *

Address Line 1 *

Address Line 2 *

City *

State *

Postal Code *

Country *

First Name *

Last Name *

Email *

Phone *

Has your company ever been a member of NIBA? *

Yes

Company Type *

Affiliate

Belting Manufacturer

Component Manufacturer

Distributor/Fabricator

Trading Company

Length in time in the belting industry *

Please list any other industry organizations of which you are a member

Briefly describe why you are interested in attending the convention *

Describe how your company is involved in or impacts the belting industry *

How did you hear about NIBA?

Please verify that you have checked the “I'm not a robot” checkbox.