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MEMBERSHIP APPLICATION

Company/Organization/Agency: ____________________________________________________________________
Correspondence to be directed to: _____________________________ Title: _____________________________
Address: ________________________________________________________________________________________
City: ____________________________________________ State: ___________ Postal Code: __________________
Country: ________________________________________________________________________________________
Telephone: _______________________________________ Fax: __________________________________________
E-mail: ______________________________________________ Website: ___________________________________
Our firm is engaged in the following:_________________________________________________________________
________________________________________________________________________________________________
Who Referred You to ISSA? ________________________________________________________________________
Signature __________________________________________________ Date: ________________________________

PLEASE CHECK THE MEMBERSHIP CATEGORY THAT BEST DESCRIBES YOUR FIRM:

Contractor Membership- $4,750.00: Individuals or firms engaged as contractors or subcontractors in the business of slurry seal,
micro surfacing, chip seal and crack treatment in the United States or Canada.

Supplier Membership- $4,750.00: Individuals or firms furnishing equipment and/or materials, or laboratories furnishing slurry systems
mix designs, to the slurry seal, micro surfacing, chip seal and crack treatment industry in the United States or Canada.

International Contractor Membership- $1,800.00: Individuals or firms that qualify for contractor membership, domiciled outside but
not engaged as Contractors in the United States or Canada.

International Supplier Membership- $1,800.00: Individuals or firms that qualify for supplier membership, domiciled outside but not
engaged as suppliers in the United States or Canada.

Associate Membership- $500.00: Individuals or firms that are not covered under one of the voting membership categories but are
deriving an income from the slurry seal, micro surfacing, chipseal and crack treatment industry. Examples of this are consulting
engineering firms.

Governmental Membership- $100.00: Government agencies interested in slurry seal, micro surfacing, chipseal, and crack treatment.

Affiliate Membership- $100.00: Professional trade associations and societies, educators and retirees.

PAYMENT INFORMATION (All amounts in U.S. Dollars drawn on a U.S. Bank):


Check enclosed made payable to ISSA. U.S. Dollars Enclosed: $ _______________________________________

Charge $ __________________ (amount due) to my credit card: VISA MASTERCARD AMERICAN EXPRESS

Card Number __________________________________________________________________ Exp. Date _________

Name as it appears on the card ______________________________________________________________________


Cardholders signature _____________________________________________________________________________

Please return this form with payment to ISSA. Please note that contributions, gifts, and dues payments to this association are not deductible
as charitable contributions for Federal Income Tax purposes. However, they may be deductible for most members under section 162 of
the IRS code as an ordinary and necessary business expense.
MISSION STATEMENT
Founded in 1963, the International Slurry Surfacing Association (ISSA) is a nonprofit association
dedicated to the interests, education, and success of slurry and micro surfacing, chip sealing and crack
treating professionals and corporations around the world. Internationally recognized as the authority in
slurry and micro surfacing, chip sealing and crack treating technology, ISSA promotes the highest
standards of ethics and quality while providing its members with information, technical assistance, and
ongoing opportunities for networking and professional development.

ISSA MEMBER BENEFITS

ISSA disseminates industry information through its quarterly newsletter, membership directory, seminars,
workshops, conventions, and website at www.slurry.org.

ISSA develops and publishes the most current technical information in the industry including slurry & micro
surfacing, chip seal, and crack treating specifications, design technical bulletins, quality control brochures,
inspectors manuals, conference proceedings and numerous other technical publications.

ISSA offers promotional materials including brochures and DVDs on slurry & micro surfacing.

ISSA exhibits at six industry trade shows annually and regularly provides speakers for technical conferences
around the world.

ISSA offers two main educational and training events a year: the ISSA Annual Convention and the Slurry
Systems Workshop. Both events provide unique opportunities for technology transfer and networking
amongst your peers. The Annual Convention is held at an international site every five years.

ISSAs Annual Convention is held in conjunction with the annual meetings of the Asphalt Emulsion
Manufacturers Association and the Asphalt Recycling & Reclaiming Association, ISSAs industry partners in
the Pavement Preservation & Recycling Alliance.

ISSA is headquartered in Annapolis, Maryland, with staff facilitating liaison with the Federal Highway
Administration, national and regional government agencies, public works agencies, engineering bodies and
divisions of the military.

ISSA members and the general public have access to the ISSA Technical Committee and its Response
Team which keeps the association and its members current on technical issues and answers any general or
technical questions on slurry & micro surfacing, chip sealing, and crack treating.

Revised October 2016