Member Application Form

FSPA Membership Application

Application is hereby submitted for membership in the Financial & Security Products Association (FSPA). FSPA reserves the right to select its members on the basis of reputation in serving financial institutions and related industries. Membership is divided into three classes: Suppliers/Manufacturers, Dealers and Associates. Associates are those serving the industry but are neither a dealer nor a supplier. Application is subject to ratification by the Board of Directors. The Applicant accepts the FSPA Code of Ethics and agrees to its By-Laws. It is understood that any violation of the same, as determined by the Board of Directors could result in revocation of membership standing.

Contact 1 Person:

Contact 1 Email:

Contact 2 Person:

Contact 2 Email:

Company:

Website:

Address:

City:

State:

Zip:

Country:

Telephone:

Fax:

Business Started:

A payment for 50% of the first year membership dues is required for the application to be processed. Annual Membership Dues are $495.00.

FSPA should send invoice credit card approval form for application fee.

Sponsor Name:

Sponsor Company:

Please provide a brief description of your company’s products and services. This information will be included in the Members Only Bulletin section of the FSPA monthly newsletter announcing your application for membership.

All applicants are requested to submit one bank reference and one trade reference UNLESS referred by an FSPA member:

Bank:

Contact:

Address:

Telephone:

Trade:

Contact:

Address:

Telephone:

This application authorizes the Financial & Security Products Association to verify references and/or confirm with my sponsor.

Authorized Signature:

Joined Association:

Print Name:

Email: