American Society of Baking

New Member Application

Please contact me at my home address or business address

FULL NAME:

Title:		Mr.Ms.Dr.
First Name:
Middle Initial:
Last Name:

Date of Birth:		/ /

BUSINESS ADDRESS:

Company Name:
Your Title:
Business Address:
Suite or Unit #:
City:
State:
Zip:
Country:

Telephone:
Fax:
E-Mail:

HOME ADDRESS:

Street Address:
Apt. #:
City:
State:
Zip:
Country:

Telephone:
Fax:
E-Mail:

BUSINESS INFORMATION:
Type of Business:

	Baker
	Equipment Manufacturer
	Ingredient Supplier
	Other

If Other, please explain:

Description of Business:
Your Current Position:
Years with Company:
Years in Industry:

Highest Educational Level (choose one):

	High School
	Baking School
	College
	Post Graduate

PAYMENT INFORMATION

We accept Visa, MasterCard, American Express, cashier's check, money order, personal or company check. If sending check or money order, do not mail cash. Payable in U.S. funds ONLY.

Membership Dues Rates

USA, Canada and Mexico:	$125
Other Countries:	$150

Make Checks payable to: American Society of Baking

Membership will be processed when payment is received. Join today by completing the payment information below and submitting this form.

Credit Card Type:		Visa Master Card American Express
Name as it appears on card:
Credit Card Number:
Exp. Date
For the Amount of:	$

AMERICAN SOCIETY OF BAKING
PERSONAL RESOURCE INFORMATION

Please indicate the ONE area in which you are qualified to offer knowledge and experience to other members.

PRODUCTION
Bread & Rolls Cake Cookies Doughnuts
Pies Sweet Yeast-Raised Products Frozen-Baked Frozen-Unbaked
Muffins Pizza Tortilla Bagels
Other

INGREDIENTS
Flour Sugar, Syrups Shortening Eggs
Dry Milk Dough Conditioners Yeast Foods Yeast
Softners Replacements Enzymes Emulsifiers
Food Additives Water
Other

EQUIPMENT
Scaling Mixing-Batch Mixing-Continuous Pan Greasing
Baking Conveying Cooling Freezing
Packaging Shipping Sanitation Maintenance
Pans Liners Wrapping Materials Handling
Other

PERSONNEL
Management Safety Employee Training
Other

PLANNING
Scheduling Layout Flow Chart Time Study
Other

MANAGEMENT
Labeling Computers Energy Labor Relations
Distribution Government Regulations Ecology Quality Control
Other

If you would like an application mailed to you or another prospective member, please contact us at:

American Society of Baking
1200 Central Avenue, Suite 360
Wilmette, IL 60091
Toll Free: 866/920-9885
Tel: 847/920-9885
Fax: 847/920-9886

or contact us via E-mail

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