Application For Corporate Silver Level Membership Company Information Corporate Silver Level Annual Dues: $300 — includes 12 members @ $25 each and a Potomac Chapter Website Sponsorship ($75). Company Name Address City State Zip Phone Fax No. Email Website Employees Participating (Names and Emails) Include the names and emails of up to 12 employees. If members of the National Society, include their membership number. Name E-Mail Business Categories Please list one or two categories that best identify the nature of your business. Category 1 Government (Agency)Blasting / Drilling ContractorsConstruction - GeneralExplosive Sales / DistributionQuarryingEquipment Mfg. Sales, ServiceVibration ConsultantOther If "Other", please specify. Category 2 Government (Agency)Blasting / Drilling ContractorsConstruction - GeneralExplosive Sales / DistributionQuarryingEquipment Mfg. Sales, ServiceVibration ConsultantOther If "Other", please specify. Submit
