HASC Member Application

Membership Application

Please review all membership and billing policies before completing all information in this application.

Terms & Policies

NEW MEMBERS: $500 per calendar year

Make your check payable to Houston Area Safety Council, Inc. and mail to:
5213 Center Street
Pasadena, TX 77505

For questions or to arrange payment call (281) 476-9900 x310

Company Name:

Mailing Address

Street:

City:

State:

Zip:

Billing Address: Same as Mailing Address

Street:

City:

State:

Zip:

Physical Address: Same as Mailing Address

Street:

City:

State:

Zip:

Contacts

Primary

First Name:

Last Name:

Title:

Phone:

Email:

CEO

First Name:

Last Name:

Title:

Phone:

Email:

Billing

First Name:

Last Name:

Title:

Phone:

Email:

Training/HSE

First Name:

Last Name:

Title:

Phone:

Email:

Link Administrator

Please designate an administrator for your account.

The administrator will be able to set up additional online registration users which will be authorized to make charges to your company account.

First Name:

Last Name:

Title:

Phone:

Email:

First Name:

Last Name:

Title:

Phone:

Email:

(888) 955-SAFE customerservice@hasc.com