20 z membership application form - responsible business€¦ · 2020 z membership application form...
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Department:Phone:
Department:Phone:
Application Company Profile: Company Name:Headquarter Address: Headquarter Phone:
Company’s w.! Primary Contact: Title: Email
Company’s RBA Secondary Contact: Title: Email:
Please describe your company’s electronics related business:
Membership Category and Annual Dues Level ‐ Annual dues are based on the company’s current annual revenue. New members pay a one‐time $5,000 application fee. For more information on membership categories, please visit the RBA website or contact the RBA at [email protected] Responsible Business Alliance membership year begins on January 1 and ends on December 31. Eligibility - RBA membership is open to companies that manufacture or contract the manufacture of a product in which electronics is a function of the product, or supply materials used in those goods. Membership Category (Choose one):
Supporter
Full Member
Dues Level (Choose one):
US $35,000 (revenue less than $9B)
US $45,000 (revenue more than $9B)
Number of Employees (All locations, choose one)
1‐499 5,000‐9,999
500‐999 10,000‐49,999
1,000‐4,999 50,000 +
Questions? Contact RBA Member Services1725 Duke Street, Suite 300 Alexandria, Virginia, USA 22314 [email protected] Tel. 571‐858‐5733
Please select the applicable categories that best describe your company’s business:
Primary Secondary Tertiary
Assembly test
Electronics components
Manufacturing services / contract manufacturer
Extractives / mining
Joint design manufacturer
Logistics
Manufacturing equipment
Original design manufacturers
Original equipment manufacturer
Recycling operations
Retailer
Semiconductor manufacturer
Services
Smelter / refiner
Software
Storage
Technology re-seller
Other (please write in):
2021 w.! Membership Application Form
1) Application must be complete and include signed commitment letter (see sampleon following page)
2) Submit completed application form and commitment letter to:[email protected]
For more information, please visit: www.NJŜǎLJƻƴǎƛōƭŜōdzǎƛƴŜǎs.org or Contact staff at [email protected]
Please tell us about your interest in RBA membership:
AffiliateRegular Member
Member Sponsor (if applicable) (Current RBA member who may have encouraged or required your company to join):____________________________________________
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Sample Commitment Letters to accompany completed RBA Membership Application Form
Commitment letters should be on company letterhead
For Affiliate, Member and Full Member Categories
Date
Address
Dear RBA Board of Directors,
On behalf of (insert company name) and in support of our application for RBA membership, I am writing to state my company’s commitment to supporting the RBA's mission, vision, bylaws, membership requirements and the Code of Conduct. In addition, our company is committed to meeting all the requirements of membership as outlined in the Membership Compliance Program.
Sincerely,
CEO (or CEO-1) Name
For Supporter Member
Date
Address
Dear RBA Board of Directors,
On behalf of (insert company name) and in support of our application for RBA membership, I am
writing to state my company’s commitment to supporting the RBA's mission and vision, bylaws and
membership requirements.
Sincerely,
Company representative