OPMA Member Application

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Ohio Pest Management Association Membership Application

Click here for printable version

Please Select A Membership Category:

Active*	View Dues Structure
Branch	$75.00
Allied (Distributors and Others)	$250.00
Associate (Manufacturers)	$500.00
Additional Active	$75.00

* Membership fees for Active Members are based on the company's sales volume for the last fiscal year.

Applicants must provide proof of insurance and verification that the company has been in business at least one year.

Application Information:
Contact Name:
Company:
Address:
City:	State: Zip:
Telephone Number:
Fax Number:
Toll-Free Number:
Which telephone number do you wish OPMA to publish? Telephone or Toll-Free
Email:
Website:
Payment Information:
Total Amount $
Charge my Visa or MasterCard
Card Number: Expiration Date:
Cardholder’s Name: