CFON Application Download the CFON Application 2021 or complete the online form below: CORPORATE FRIEND OF NRRTS APPLICATION (CFON) NATIONAL REGISTRY OF REHABILITATION TECHNOLOGY SUPPLIERS A Corporate Friend of NRRTS (CFON) is a manufacturer or CRT Supplier involved in the rehabilitation technology industry that distribute its products through a supplier network or a CRT Supplier. A CFON must be sponsored by a NRRTS Registrant in good standing and approved by the Board of Directors of The National Registry of Rehabilitation Technology Suppliers as meeting all standards and requirements. The annual fee is $1500. Five (5) complimentary FON affiliations (IFONs have access to NRRTS Education at 50% off and can participate on the NRRTS Listserve and a subscription to DIRECTIONS Magazine) CFON corporate logo with hot link to corporate CFON web site on www.nrrts.org Right of First Refusal on Event Sponsorships CFON corporate logo on the back cover of DIRECTIONS Magazine. NRRTS Registrant Name (Sponsor)* First Last Company Name* Cell Phone*Email* I recommend the company noted above is an asset to our industry and will be an honorable CFON. Signature of NRRTS Registrant -NRRTS will obtain on your behalf if you don't have one.(Proposed) Corporate Friend of NRRTS informationCFON Primary Contact (name of individual)* First Last Company Name* Corporate Phone Number*Company Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Primary Contact Name* First Last Primary Contact Cell Phone*Primary Contact Email* Company Phone*Rehab Products and Services Supplied: (Check all that apply)*Wheeled mobilitySeatingAlternative positioningAugmentative communicationADL ProductsOther (please list)If you chose "Other" please describe:Complimentary Corporate Friends of NRRTS affiliationsPlease provide name and contact information for the (5) complimentary Corporate Friends of NRRTS affiliations. 1. Complimentary CFON* First Last Email* 2. Complimentary CFON First Last Email 3. Complimentary CFON First Last Email 4. Complimentary CFON First Last Email 5. Complimentary CFON First Last Email Corporate Friend of NRRTS (CFON) applicant Signature*Proposal will not be processed without signature of proposer, CFON primary contact and Date. Date Signed MM slash DD slash YYYY An annual renewal will be sent in January of each year to request updated published information about the organization and an update on its contribution to the rehab industry. Send completed form, payment of $1500USD (NRRTS can invoice), high-resolution logo in JPEG (minimum of 300 dpi) to Amy Odom
