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Please complete the following application. Note that * is required information.

Please Note: Pest control companies headquartered in the following states must click on their state for a joint membership application. Fill out the application and send application with dues payment to the address listed for your state (on the bottom of each application). 

AR, AZ, CO, CT, DE, FL, IA, ID, IL, IN, KS, KY, MA, MD, ME, MI, MN, MO, NC, NE, NH, NJ, NM, NY, OH, OK, OR, PA, PR, RI, SC, TN, TX, VA, VT, WA, WI, WV

Canada:  Click on your province and fill out the application and send with dues payment to the address listed on the application.

Alberta,  Atlantic,  British Columbia,  Ontario,  Quebec,  Canadian Supplier Application

If you have any further questions, please contact Jean Neun at 703-352-6762 or . If you wish to contact your state association or want more information about your state association, please click on this link, https://www.npmapestworld.org/IndustryLinks/Industry.asp, for the websites of our joint state associations.

If you are not a pest control company headquartered in any of the states above or are not a pest control company, please fill out the application below and submit to Jean Neun at NPMA.

Contact Name: 
  *
Title: 
  *
Company Name: 
  *
Address: 
  *
Address 2: 
  
City: 
  *
State/Province: 
  *
Zip: 
  *
Country:
Phone: 
  *
Fax: 
E-mail address: 
  *
Web Address: 
 
Addresses of additional branches:
   
   

Does your company belong to a state pest control association?
Yes No

If you answered 'yes' to the previous question,
which state association does your company belong to?


Please type the color of the third character:
Dues Schedule
Please select the appropriate category:
 Pest Mgmt Companies(Domestic)  Allied/Supplier (Domestic & Int'l)
 International Pest Mgmt Companies  Associate

The following dues schedule applies only to pest control operators/companies 
in the United States and (not including states in the above list) its territories (including Puerto Rico, Guam
U.S. Virgin Islands and Marshall Islands).

Company Sales Volume
Please select in the box
Annual Membership Dues
(July 1, 2009 - June 30, 2010)
   

The following dues schedule applies only to pest control operators/companies 
in the United States and (not including states in the above list) its territories (including Puerto Rico, Guam
U.S. Virgin Islands and Marshall Islands).

Company Sales Volume
Please select in the box
Annual Membership Dues
(July 1, 2009 - June 30, 2010)
   


  
Payment
  

If you prefer to pay by check, please print this form and send with your payment to:

National Pest Management Association
ATTN: Membership Department
10460 North Street
Fairfax, VA 22030 USA

Please make checks payable in U.S. Dollars to NPMA.
Payment Information:

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As a safeguard, you must enter your credit card's verification number, which is printed on the card (printed on the back of Visa and MasterCard and the front of Amex).
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Expiration
  

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