HASC Membership Application
Please review all membership & billing policies before completing all information in this application.

TERMS & POLICIES

New Membership Fee is $500
Membership Renewal: $300 Annually

Make your check payable to HASC, Inc. and mail to:
Attn: Customer Service
5213 Center Street
Pasadena, TX 77505

Or contact the customer service department to arrange payment by credit card.

The $300 annual membership fee is due each year by January 1. Payments not recieved by January 15 will result in cancellation of membership including all benefits such as billing privileges, online registration, and discounted prices.

Email us if you have any questions.

Please Complete All Information:

Company Name:

Billing Address:

Street:

City:
State:
Zip:

Billing Contact:

Name:
Phone:
Fax:
Email:

 

Please provide the following contacts for your company:

CEO/President:

Mailing Address:

Street:

City:
State:
Zip:
Phone:
Fax:
Email:  

Training/Safety Manager:

Mailing Address:

Street:

City:
State:
Zip:
Phone:
Fax:
Email:

By submitting this form, I have read and understand the information above and agree with the terms and policies established by HASC, Inc. in granting my company billing priviledges as a member.