Corporate Friend of NRRTS (NO PAYMENT)

Corporate Friend of NRRTS Application (NO PAYMENT)

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 information
CFON 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 Country
Primary Contact Name*
First Last
Primary Contact Cell Phone*
Primary Contact Email*
Company Phone*
Rehab Products and Services Supplied: (Check all that apply)*
If you chose "Other" please describe:
Complimentary Corporate Friends of NRRTS affiliations
Please 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

Corporate Friend of NRRTS Application (NO PAYMENT)

(Proposed) Corporate Friend of NRRTS information

Complimentary Corporate Friends of NRRTS affiliations