NENA Application

National Emergency Number Association
Application for Membership
Membership Categories

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Active
Membership
$75.00

Active – Any management, supervisory or support personnel responsible for planning, organizing, staffing, direction, controlling, supporting and / or operation functions required in the design, promotion, construction, installation, maintenance, command and / or operation of public safety emergency communications systems who are employed compensated, appointed, or elected by a federal, state, provincial, territorial or local government agency, or an agency substantially supported by government funds or retired from one of the above categories.  All Active Members automatically become members of their State / Provincial Chapter if one exists.

Commercial
Membership
$75.00

Commercial  – People in the business sector who receive compensation from the design, manufacture, sale, service, maintenance, lease, rental or promotion of equipment or systems which are used or can be used in public safety emergency systems and those persons who are engaged in writing, publishing, advising and consulting in the public safety emergency communication field or who distribute goods and represent companies, firms or persons including themselves and others engaged in such activities.  All commercial Members automatically become members of their State / Provincial Chapter if one exists.

Associate
Membership
$40.00

Associate  – Those persons not eligible for Active or Commercial classes of membership;   those persons involved in the emergency communication field in a capacity of support personnel or in non-supervisory or non-management positions; those persons who have otherwise qualified for Commercial or Active membership but are no longer employed or active in the emergency communication field; or persons with no direct or indirect connection to the emergency communications field in any way but wish to support the goals and objectives of NENA.  This classification has restrictions.

Select the appropriate membership category from those described above.
[  ] Active – $75.00 [  ] Commercial – $75.00 [  ] Associate – $40.00

(Please Print)

Name                                                                                                                

Title / Position                                                                                                

Job Function                                                                                                   

Organization                                                                                                   

Address                                                                                                          

City, State, Zip Code                                                                                    

Daytime Phone                                                                                              

Fax                                                                                                                  

Referred by:                                                                                                    
Credit Card Payment: [  ] Visa [  ] MasterCard [  ] American Express

Account #                                                                   Exp. Date                    

Signature                                                                                                          

Member Profile
Select one in each section
Employer Category
[  ] 01 9-1-1 Board
[  ] 02 Government Agency
[  ] 03 Telephone Company
[  ] 04 Independent System Provider

[  ] 05 Consultant Services
[  ] 06 Equipment Vendor/Distributor
[  ] 07 Equip. Manufacturer/Developer
[  ] 08 Police Department
[  ] 09 Fire Department
[  ] 10 EMS
[  ] 11 Other                                       

Job Classification
[  ] 01 Director, Agency Head, Supervisor
[  ] 02 Marketing/Sales
[  ] 03 Project Engineer/Systems Designer
[  ] 04 DB Manager/DB Developer/Addressing
[  ] 05 Data Base/Clerical
[  ] 06 Education & Education
[  ] 07 Emerg. Responder, Service Provider
[  ] 08 Dispatcher/Call/Radio Operator
[  ] 09 Equip. Installation/System Installer
[  ] 10 9-1-1 Coordinator
[  ] 11 Other                                       
[  ] 12 9-1-1 Product Manager
[  ] 13 County Elected Offical

Send this completed membership application and payment to:
NENA – 47849 Papermill Rd * Coshocton, Ohio 43812-9725
Credit card payments may be faxed to: (740) 622-2090
NENA National Office – 1-800-332-3911