Application for Membership
Membership in the organization is open to public or private sector hazardous materials emergency response teams in North Carolina or individuals who support the mission and goals of the NCAHMR.
There are two types of memberships:
- Hazmat Team Membership
- (for public or private sector hazmat teams providing emergency response services.)
- Associate Membership
- (for those individuals involved with or supporting the hazmat community in North Carolina).
Please complete the form below and mail, with the appropriate dues, to the address provided below.
(PLEASE PRINT)
Name: _______________________________________________________
Agency:______________________________________________________
Address:_____________________________________________________
City, State, Zip:________________________________________________
Phone: (where you may be easily contacted): __( )-______-__________
Fax: _________________________________________________________
E-Mail Address:________________________________________________
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If you are applying as a Hazmat Team, please provide the name of a primary and alternate representative:
Primary: ______________________________
Alternate: ______________________________
Included Dues (check one) :
_____ Team Membership - $100 per Hazmat Team
_____ Associate Membership - $20 per person
Remit application and dues to:
N.C. Association of Hazardous Materials Responders
c/o Chief Frank Burns
P.O. Box 429
Kings Mountain N.C. 28086
