Name of Company or Individual (full names of Partners, if partnership firm)

Telephone

Full Postal Address (including postcode)

Representative to whom all correspondence should be addressed and who is authorised by us to vote at General Meetings will be (you may enter up to 3 names)

Email Address

Website URL

Category of Membership Required Category of Membership Required Contractor Supplier Assocaite or Overseas University Personal

Are you a contractor offering Thermally Sprayed Coatings? Are you a contractor offering Thermally Sprayed Coatings? Yes No

Are you creating Thermal Sprayed Coatings 'in house' for repairs or as part of your manufacturing processes? Are you creating Thermal Sprayed Coatings 'in house' for repairs or as part of your manufacturing processes? Yes No

Please give a brief description of the Thermal Spray Process(es) used and the type of work undertaken.

Are you an equipment or material supplier? Are you an equipment or material supplier? Yes No

Please give a brief description of your range of products

Are you otherwise associated with Thermal Spraying? Are you otherwise associated with Thermal Spraying? Yes No

Please state (eg Consultant, Institute, etc)

Can you name a member of the Association as a referee Can you name a member of the Association as a referee Yes No

If so, please give name and address

Please supply your Company Purchase Order Number

Your Name

Position