American Pet Products Manufacturers Association, Inc.
255 Glenville Road
Greenwich, CT 06831
Tel: (800) 452 1225   Fax: (203) 532 0551


MEMBERSHIP APPLICATION FOR MANUFACTURERS' REPS

Manufacturers' Representative Membership is open to all pet product manufacturers' representatives. The undersigned hereby makes application for Manufacturers' Representative membership in American Pet Products Manufacturers Association, Inc. (APPMA) and, if accepted for membership by the Board of Directors, agrees to abide by all the Rules, Regulations and By-Laws of said Association.

Directions: Please complete this form in its entirety by typing your response or, where appropriate, indicating "Not Applicable." Incomplete information or documentation will delay processing and consideration of this application. The information contained in this application will remain confidential except to the extent necessary for consideration of membership and/or provision of member services or if permission is granted by applicant in item number 9 on this application.

Company and Key Contact Information
Firm Name:
Contact Name:
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:	(Please include area/city and country code)
Fax:	(Please include area/city and country code)
E-mail Address:
Web Site URL:
Business Profile:
2. Name the type of business the applicant is organized as (e.g., corporation, partnership, sole proprietorship, etc.):
3. Are you a representative of products manufactured by at least two pet products manufacturers?: Yes   No Please provide the following information for at least two different manufacturers that you represent. References need not be APPMA members. Information will remain confidential and will be verified by APPMA representatives.
Firm Number 1
Firm Name:
Contact Name:
How many years have you represented this firm?
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:	(Please include area/city and country code)
Fax:	(Please include area/city and country code)
E-mail Address:
Firm Number 2
Firm Name:
Contact Name:
How many years have you represented this firm?
Address:
City:
State/Province:
Zip/Postal Code:
Country:
Phone:	(Please include area/city and country code)
Fax:	(Please include area/city and country code)
E-mail Address:
4. Are the pet products you represent being sold inside the United States or outside of the United States? Inside the United States Outside the United States Both
5. How many pet products manufacturers do you currently represent?
6. Number of Employees. Indicate the number of full-time employees in your company (employees in pet products division only). Company information will remain strictly confidential.: Less than 5 6 - 10 11 - 25 26 - 50 51 - 100 More than 100
7. What territory(ies) or region(s) do you primarily represent?
8. What product types do you primarily represent? Any/All Specifically those listed below:
9. Do you want your company name, contact name, territory and main product types listed in a directory that may be part of a matching program between APPMA Manufacturing Members and APPMA Manufacturers' Representative Members? Yes   No
10. Please certify your agreement to the following statements by placing your initials in the space provided:   While on the APPMA Show floor, I agree to represent only APPMA members' products. I understand that I may represent non-APPMA member products at any time other than on the APPMA Show floor.   While on the APPMA Show floor, I agree to represent/sell products only within booth perimeters, and to represent/sell only the products belonging to the exhibitor within their booth perimeters.
11. I certify that the above information is correct as stated. I understand that should this information be incorrect, this application will be rejected. I further understand that if the application is accepted and later discovered to be incorrect, my company's membership will be terminated.
12. Membership applications withdrawn before presentation to APPMA's Board of Directors will be assessed a $75.00 processing fee. No credit or refund will be issued for the withdrawal of a membership application after the Board's approval, regardless of reason.
Signature:   Date:   As an Officer of:

American Pet Products Manufacturers Association, Inc.
Manufacturers' Representative Application Checklist

Please be sure to include the following enclosures:

• Application signed by an officer of the applicant's company. (Items left blank or unclear constitute an incomplete application which cannot be considered.)
• Full contact information for at least two of the manufacturers that you currently represent. (as indicated in item #3 of this application)
• Initiation fee $250 plus first year's plus first year's dues of $350. Payment must be made in U.S. dollars either by check, money order, wire transfer or credit card (MasterCard, Visa or American Express).
• Contributions or gifts to APPMA are not tax deductible as charitable contributions for federal income tax purposes. However, they may be deductible as ordinary and necessary business expenses subject to restrictions imposed as a result of APPMA's "lobbying" activities as defined by the Budget Reconciliation Act of 1993. APPMA estimates that the nondeductible portion of your dues — the portion that is allocable to "lobbying" — is 20%.

Please mail the completed application, initiation fee and dues payment in U.S. dollars to:

APPMA Membership Dept.
255 Glenville Road
Greenwich, CT 06831