New Membership – A&I Application

Adjuvant and Inert Ingredient Member

CPDA MEMBERSHIP APPLICATIONAND DUES CALCULATION FORM

Should you have any questions please email or call Terry Kippley, CPDA President at tkippley@cpda.com – (630) 544-9677, or Carrie Haakana at chaakana@cpda.com – (202) 531-2232.

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Invoicing Contact Name (if different)

Adjuvant/ Inert - Adjuvant manufacturer or supplier, and/or, inert ingredient manufacturer or supplier used in the production of adjuvants including pesticides. CPDA annual dues are based on company net sales of agricultural production technology products (U.S. sales only). Information regarding Membership Dues is confidential for internal use only by CPDA staff for the purpose of calculating membership due amounts.

Please check a category below that represents your company's most recent year-end U.S. net sales: *