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ASC Membership Information Request Form

Full Name (required) Title Company Address Line 1 Address Line 2 City State/Province Zip/Postal Code Country Phone (required) Fax E-Mail (required) Website

What type of business is your company? Manufacturer - manufactures (i.e any step involving formulating or repackaging) adhesives or sealants for merchant sale in North America or uses internally (captive sale) in the manufacture sor self-adhesive tapes, labels, or similar products or sale in North America (U.S, Canda, and/or Mexico). IN case a member manufactures or sells adhesives and/or sealants, and in addition supplies raw materials or equipment to the industry, the member may choose either Manufacturer or Supplier class of membership
Supplier - engaged in the sale of 1) raw materials, 2) packaging materials, 3) processing, packaging, or application/dispensing equipment to manufactureres of adhesives or sealants as well as adhesive and sealant end-users in North America and/or 4) toll manufacturers adhesives or sealants for Manufacturers. In case a member supplies raw materials or equipment, and in addition manufactures (including toll) or sells adhesives and/or sealants to the North American market, the member may choose either Manufacturer or Supplier class of membership.
Service Supplier - a market research or technical consultant affiliated with and works IN THE NORTH AMERICAN adhesives and sealants industry
Distributor - a company that buys and resells finished adhesives, sealants and/or application equipment to NORTH AMERICAN-BASED end-users
Affiliate Manufacturer - a company that manufactures and sells adhesives and/or sealants globally, but maintains all sales and manufacturing operations OUTSIDE of North America.
Affiliate Supplier - a company that supplies raw materials to the industry globally but maintains all sales and manufacturing operations OUTSIDE of North America

What products does your company supply (must select at least one)? Adhesives
Sealants
Films/Tapes/Labels
Raw Materials (used in Adhesive/Sealant Formulation
Equipment (Processing, Application/Dispensing)
Other

What end-user applications does your company supply to (must select at least one)? Assembly (includes Durables, Electronics, Medical Devices)
Building/Construction
Consumer/DIY
Packaging/Converting (including Tapes)
Leather/Footwear
Nonwovens
Transportation
Wood Products
N/A
Other

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© 2012 The Adhesive and Sealant Council | 7101 Wisconsin Avenue, Suite 990 | Bethesda, Maryland 20814
Phone: (301) 986-9700 | Fax: (301) 986-9795