Non-Profit Membership Application

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Please fill out the form below to apply for a non-profit or government-level membership with the NBIH. Once submitted, your application will be reviewed. If approved, your credit card will be charged for the yearly membership fee and you'll receive a welcome packet via e-mail on how to to proceed.

 
1

Enter Business/Organization Information

Business/Organization Name

First Name

Middle Name (if applicable)

Last Name

Professional Title

Primary Telephone Number

Cell/Other Phone Number

Email Address

 
2

Enter Physical Location

Physical Address

City

State/Province

Zip/Postal Code

Country

 
3

Enter Business Qualifications

Please enter the achievements of your business or organization below.

Corporate/Tax/IRS ID # (if applicable):

State Contractor's License # (if applicable):

Additional Licensing/Certifications

Additional #1 - Type

Additional #1 - Description

Additional #2 - Type

Additional #2 - Description

 
4

Enter Billing Information

We accept Visa, Mastercard and American Express. We do not accept POs, checks, or invoices to be paid at a later date.

First Name

Last Name

Card Number

Type
 Card Types

Expiration
 

CVV
 cvv

Billing Address

City

State/Province

Zip/Postal Code

Country

Billing Phone Number

 
5

Confirm Your Membership Application

Your membership is $175.00 every year.

By submitting this application, I endorse the validity of the information provided. If approved for membership, I agree to follow and be in compliance with NBIH required Code of Conduct and Ethical Principles. I understand that membership is non-transferable and that membership fees are non-refundable.

Membership with the National Board of Industrial Hygiene is annual. You may choose not renew at the end of the twelve-month term.

The NBIH does not charge sign-up or registration fees for Non-Profit Level Membership.

Please review our Terms of Service and Privacy Policy

If you have any questions please email support@nbih.org.

I agree to the Terms of Service and Privacy Policy.