Robotics Online - RIA - Robotic Industries Association
Become a Member

Systems Integrator - Gold

Please fill out the information below and click on the 'submit' button. Click here to go back to benefits.

Fields marked with * are required. Your form submission WILL be encrypted using SSL to ensure your privacy.

BUSINESS INFORMATION
Company Information
Company Name: *
Country: *
Address: *
 
City: *
State: *
Zip Code: *
Province: *
Postal Code: *
Phone: *
Fax: *
Website Address:
Master Contact Information
The Master Contact will receive membership renewal notices, important updates and will serve as your company's main liaison with RIA. You must have a master contact, please be sure to notify us if there is a change in personnel.
 
First Name (given name): *
Last Name (family or surname): *
Job Title: *
Email: *
Telephone: *
Billing Contact Information
If no billing contact designated, membership renewal invoices will be sent to master contact.
 
First Name (given name):
Last Name (family or surname):
Job Title:
Email:
Telephone:
Marketing Contact Information
This person will receive your annual Print Directory listing update requests. If no marketing contact designated, this will be sent to master contact.
 
First Name (given name):
Last Name (family or surname):
Job Title:
Email:
Telephone:
Other
How many employees work for your organization? *
 
End product(s): *
characters left
Company Description: (1000 characters or less) *

characters left
Classification/Product Type: * (Check All That Apply - At Least One is Required)
 Accessory Equipment Supplier
 Cable
 Consultant
 Controls
 End-of-Arm Tooling
 Engineering Services
 Robot Distributor
 Robot Manufacturer
 Robot User
 Robotic Safety Equipment
 Robotics Researcher
 Software (programming, simulation, etc.)
 System Integrator
 Used Robots
Industries Served: * (Check All That Apply - At Least One is Required)
 Aerospace
 Agriculture
 Arc Welding
 Automotive
 Automotive Component
 Biometrics/Security
 Building Products/Materials
 Chemical
 Consumer Goods/Appliances
 Containers
 Defense/Military
 Education
 Electronic/Electrical
 Fabricated Metals
 Food/Beverage
 Furniture
 Life Sciences Pharma Biomed Medical Devices
 Metals
 N/A
 Off-Road/Heavy Equipment
 Other
 Paper
 Pharmaceuticals
 Printing & Publishing
 Robot Manufacturing
 Rubber & Plastics
 Semiconductor
 Textiles
 Wood Products
Application Types: * (Check All That Apply - At Least One is Required)
 Arc Welding
 Assembly
 Assembly < 10 Lbs
 Assembly > 10 Lbs
 Coating
 Dispensing
 Inspection
 Material Handling
 Material Handling Packaging and Palletizing
 Material Handling < 10 Lbs
 Material Handling > 10 Lbs
 Material Handling Body Shop
 Material Handling Machine Tending
 Material Handling Parts Holding
 Material Handling Parts Transfer
 Material Removal & Cutting
 MR Cutting / Deburring / Grinding
 MR Machining
 N/A
 Other
 Safety
 Simulation
 Spot Welding
The top three things I want from RIA Membership are:
1.
2.
3.
PAYMENT INFORMATION
Reference:
Payment Option
Payment Option: Invoice Me Pay By Credit Card
To pay by check or money order print this form and send with payment to Automation Technologies Council, 900 Victors Way, Suite 140, Ann Arbor, MI 48108, USA. Checks must be in U.S. dollars drawn from a U.S. bank.
Amount:
Credit Card Type:
Credit Card Number: (do not enter dashes or spaces)
Credit Card CSC: (3 or 4 digit number on the back of your card)
Expires: / (mm/yy)
Name:
(as it appears on card)

Leave this field empty
Automated Imaging Association Motion Control Association