NIAIMA Application 2024

NIAIMA Membership Application

NIAIMA (Northeast Illinois and Indiana Industrial Mutual Aid) was organized in 1971 by four petroleum companies located in northeast Illinois. Participation in NIAIMA is open to petroleum refineries and petrochemical industry members and approved associated members located in northeast Illinois and northwest Indiana.

I/We hereby apply for membership in NIAIMA (Northeast Illinois and Indiana Industrial Mutual Aid). in the following category:(Required)

Full Membership (Full Member shall be open to industries handling flammable liquids and hazardous chemicals with (similar) potential of vapor release or fire occurrence in which additional aid beyond plant and municipal facilities might be served. Voting privileges are reserved for Full Members.) Members of NIAIMA must have dues paid up to date and be active members of the Three Rivers Manufacturers’ Association (TRMA). Members must sign the NIAIMA Bylaws & Manual.

Associate Membership (Associate Member shall be open to suppliers of fire and emergency equipment and services, which may be needed during an emergency situation occurring in a Full Member facility. Associate Members shall have no voting privilege.) Members of NIAIMA must have dues paid up to date and be active members of the Three Rivers Manufacturing Association (TRMA). Members must sign the NIAIMA Bylaws & Manual.

Company/Organization Information:(Required)

Company Name

Company Address

Street Address Address Line 2 City ZIP Code

Primary Contact(Required)

First Last

Primary Contact Email(Required)

Primary Contact Phone #(Required)

Secondary Contact(Required)

First Last

SecondaryContact Email(Required)

Secondary Contact Phone #(Required)

Please provide a brief description of your organization:(Required)

Please select your preferred invoice delivery method:(Required)

Credit Card (details to be coordinated with TRMA Accounting upon membership approval)

ACH payment option (details to be coordinated with TRMA Accounting)

Delivered via email address (Please provide billing contact and email address)

Delivered via US Mail Postal address (Please provide billing contact and email address)

Name(Required)

First Last

Email(Required)

Important Membership Information:

Membership becomes effective on the first day of the following month from the approval of a majority of the Board of Directors. Payment must accompany this application. Completion of this application does not constitute acceptance as a member. Members must sign the NIAIMA Bylaws & Manual — these documents will be provided upon membership approval.

Total

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