Clone of NEW SAMA Manufacturer Membership Registration Form

SAMA Manufacturer Annual Membership

Welcome to Our Manufacturing Association! As part of our commitment to supporting your growth and success, we kindly ask you to fill out this brief questionnaire. Your responses will help us understand your needs and tailor our services to better assist you.
Company Name
Years In Business
Address:

Street Address

Street Address Line 2

CityState

Zip Code
County of Manufacturing Facility
Primary Member's Name

First NameLast Name
Primary Member's Title/Role
Primary Member's E-mail Address
example@example.com
Phone Number
Number of Employees
Annual Revenue
Manufacturing Sub-Industry Sector
NAICS code:
A manufacturing NAICS code is required for immediate acceptance within SAMA. Other manufacturers will require SAMA Board of Director's approval.
DUNS Number:
Do you participate in the DoD Supply Chain?
Referred By:
Company Logo Upload

Browse Files
Members will have a hotlink to their website. Upload your logo here. Accepted file types: jpg, gif, png, pdf, ai, psd, Max. file size: 100 MB, Max. files: 2. Cancelof
Company Website
Please enter the website where you would like the hotlink from your logo to send the user.
CEO/President's Name

First NameLast Name
CEO/President's Email Address
example@example.com
CFO/Accountant's Name

First NameLast Name
CFO/Accountant's Email Address
example@example.com
Operations/Production Mgr's Name

First NameLast Name
Operations/Production Mgr's Email Address
example@example.com
HR Director's Name

First NameLast Name
HR Director's Email Address
example@example.com
Sales/Marketing Director's Name

First NameLast Name
Sales/Marketing Director's Email Address
example@example.com
What are your main products/services?
Are you willing to serve on an SAMA Committee?
Membership Type
Number of Employees (Standard Membership)
Not sure which membership type is the best fit for your company? View our Membership Structure and Benefits.
How are you paying?

Membership Level options

Standard Manufacturer Membership$295.00

Dues dependent on employee count at local facilities, and will be verified.

Employee Count
Item subtotal:

Elite Manufacturer Membership$895.00

Premier Manufacturer Membership$1,495.00

Enter coupon

Total $0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

Should be Empty:

SAMA Manufacturer Annual Membership

Membership Level options*

Membership Level options