HASC Membership Application

Membership Application

HASC Membership Application

The HASC membership fee of $500.00 is due before activating a member account. Renewal of the HASC annual membership is currently $450.00 per year and is subject to change.

Note: If you or your company already have a LINK Login Account, please Click here to log in.

Company Name:

Company Physical Address

Street:

City:

State:

Zip:

Company Billing Address

Same as Physical Address

Street:

City:

State:

Zip:

Company Mailing Address

Same as Physical Address

Street:

City:

State:

Zip:

LINK Administrators

Please designate two administrators for your account.

The administrator(s) 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:

Primary Contact

First Name:

Last Name:

Title:

Phone:

Email:

Billing Contact

First Name:

Last Name:

Title:

Phone:

Email:

Training/HSE Contact

First Name:

Last Name:

Title:

Phone:

Email:

Payment Info

Credit Card Number:

CC Expiration:

CCV:

Email address for membership payment receipt:

(888) 955-SAFE customerservice@hasc.com