Membership Application Form

Referred by

Name*

First NameLast Name

Position/Title*

Company Name*

Company Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Email*

example@example.com

Phone Number*

Area CodePhone Number

Select Membership Type

My Products*

Regular MembershipBuilder/Installer, Retail Store, Investment Firm, Service Company or Professional Pool Mgmt

$747.00 Quantity

CAT 2 Auxillary Each additional location or company brand of a builder, service retail, or professional pool management company that holds a regular membership, or a single location membership seeking membership in an additional NESPA Chapter, or a company that is located outside of the NESPA Region that is a member of PHTA and establishes a branch, location, or brand in a NESPA Chapter.

$585.00 Quantity

Single Person Service Company Product Image

Single Person Service CompanyPerson servicing and maintaining swimming pools, spas, hot tubs, water features.

$335.00 Quantity

Professional AffiliateFirms or individuals that provide professional services. Includes consultants in designing, building, and operation, architects, landscapers, finance and lending firms, bookstores, advertising, PR, and insurance agencies/agents.

$585.00 Quantity

Allied SupplierManufacturers and distributors not directly related to the manufacture or operation of pools, spas, or hot tubs, but more related to the backyard experience.

$585.00 Quantity

Commercial Facility An entity operating a single commercial or semi-public swimming pool, spa, or hot tub facility.

$585.00 Quantity

Professional Pool Operator Product Image

Professional Pool OperatorIndividual employed by a firm outside the pool and spa industry or by a professional pool management firm.

$150.00 Quantity

Associate Individual associated with a nonprofit organization, government entity, trade or professional association, research or academic institution.

$100.00 Quantity

CAT 3 AuxiliaryAny full time employee or wholly owned branch operation of a member trading under the same company name and same industry segment as parent firm. Parent company must be a member for application to be approved. Must list PHTA Parent Company below.

$100.00 Quantity

RetireeIndividual formerly in the pool and spa industry for 10 years and is at least 55 years old and is no longer working in the industry.

$50.00 Quantity

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

CAT 2 Auxillary - Please list the NESPA/PHTA Member Parent Company

CAT 3 Auxillary List PHTA Member Parent Company

Please indicate the benefits you are interested in:

How long has the company been in business*? *If less than one year membership representative will conduct personal interview.: *

List state/local licenses & registration numbers, if applicable:*

Do you have any special skills or interests you would like to contribute as a member?

Does the company have any unresolved consumer complaints?*

YesNo

If Yes, Provide brief explanation:

Has the company or its principals ever used the NESPA (or PHTA) logo in violation of NESPA (or PHTA) bylaws?

YesNo

Has the company or its principals been found guilty of any criminal offense (excluding traffic tickets)

YesNo

If yes, provide date and nature of charge:

Has the company/applicant been a member of NESPA (and PHTA previously?

YesNo

If yes, under what name?

Liability insurance company name: *

Bank name: *

List 1 NESPA (or PHTA) member references - include Contact full name, company name, phone, and/or email :*

Date

Membership Application Form

Additional Information