The Association for
Hose and Accessories Distribution
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NAHAD Hose Safety Institute Manufacturer & Associate Application
Manufacturer & Associate
All new Institute Memberships are provisional; compliance with all Institute Membership Requirements must be attained within six months of joining.
Company Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Telephone:
Exam Coordinator:
Name:
Email Address:
Phone:
Hose Safety Institute Membership Agreement
By becoming a member of the Hose Safety Institute you agree to all
Institute Membership Requirements
, including ensuring all company employees have access to the Handbook.
Principal's Name:
Date:
Email:
Institute Membership Fee (please select all that apply):
choose one
Hard Copy- $215
Electronic Version- $129
Handbook
choose one
2 Exams $79 Each $158
5 Exams $69 Each $345
10 Exams $59 Each $590
$158 2 Exams (minimum required)
- denotes required fields
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