HMS Associate Member Application Form

Hazardous Materials Society

HMS Associate Member Application Form

Fill up the below form to become an associate member.

"*" indicates required fields

Company Name*

Company Address*

Street Address City State / Province / Region ZIP / Postal Code Country

Contact Person*

Contact Person Email*

Contact Person Telephone*

Description of Goods or Services provided to the hazardous materials | dangerous goods | environment | health & safety communities of practice*

Annual Contribution for 2020-2021 ($599):

There are two options for payment:

Option One – Pay by Credit Card:

HMS Associate Member Application Fee

Pay by Credit Card

Card Details

Cardholder Name

Option Two – Pay by Check

If payment is by check accompanied by this form, the form and check is sent to

Accounts Payable Department
Hazardous Materials Society
9210 Corporate Blvd, Suite 470
Rockville, MD 20850