Membership Application

We apoligize but our web form is currently not working properly.  Please  click on the Membership Application join here link to download a PDF file application.  We hope to get this issue resolved soon. Join Here 

Personal Information

Name:   

 

Mailing Address Preferred:

 

Residence:

 

Business:

 

E-Mail: 

 

IHMM Certification Level
Certification Level:     Certification No.: 
 
Membership
Type Of Membership: 

  • Affiliate Member ($25/ year): A professional in the field of hazardous materials management who is not certified as a hazardous materials manager.

  • Certified Member ($25/year): Certified Hazardous Materials Manager

  • Student Member ($10/year): A full-time student at an accredited college, university or institution

Directory Listing
We plan to provide a list of members, subject of expertise and contact information in a secure, password protected, members only section of our web site.  The purpose of this is to provide a source of networking contacts to fellow members.  Contact information will be email address only.  No phone numbers will be listed. 

I to be listed in the Queen City ACHMM Members Directory.

Areas Of Expertise:

Bio:

 

Username and Password
Please select a Username and Password to be used by you to access our discussion forum and secure directory.  Please choose something that you can remember and is at least 6 characters, numbers or combination.

My Username:

My Password:

 

Additional Information
If you have any additional information or comments, please list them here.

 

Click "Submit Application" below, then submit your dues as described below.
 

Make checks payable to: Queen City ACHMM

Mail payment to:

Queen City ACHMM
P.O. Box 473271
Charlotte, NC  28247



Or deliver to the Treasurer at the next chapter meeting.