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Personal Information: |
Business Information: |
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Name (with
spouse's name)
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Company
Name
Position
|
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Home Address
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Company Address
|
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City
State
Zip
|
City
State
Zip
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Home
Telephone
Email
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Company
Phone
Email
|
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Send NACC
Mailings to:
Home: _______ Office:
_______ Email: _______ |
Company
Fax
Company Website
|
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Which information in NACC membership
directory? Personal: _______ or
Business:
______ (Check only one)
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Describe
your products and services for inclusion in the yearly NACC
membership directory:
|
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Nature of your relationship to Norway?
__________________________________________________________
Does you company do
business with Norwegian companies? ____________
Norwegian products? ____________ |
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Is
your company a Norwegian subsidiary? Yes:
_____ No: ____ Percentage of Norwegian
ownership? ____ %
Name of Norwegian parent
company: |
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If
you are applying as a NEW member, include names of 2 NACC
members who are nominating you for membership
1. 2. |
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Dues Categories
(check one)
_____
$210
Corporate Member _____ $70 Individual
Member _____
$25 Student Member |
|
Corporate
membership includes 2 additional NACC members. Please list
member contact information:
1. 2.
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Please print this form, make your check payable to
"NACC" and send the completed form to:
