NH Pyrotechnic Association
Official Membership Application
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1. Membership Category
-- Select Membership Type --
Single ($100)
Family ($130)
Newsletter Only ($20)
2. Applicant Name
2. Family Information
Other Family Members
3. Contact & Employment
Email
Home Phone
Mailing Address
City
State
Zip
Occupation
Work Phone
Work Address
4. Pyrotechnic Background
Member of PGI?
-- Select Option --
Yes
No
Convicted felon?
-- Select Option --
Yes
No
Felony Explanation
Sponsor
Started Pyro (Year)
BATF License #
Display License States
5. Training & Experience Checklist
No Experience
Spot Shows
Equipment/Box Tender
Manual Displays
Lead Technician
Electrically Fired
Computer Fired
Proximate/Indoor
Shell Builder
Manufacturer
Additional Experience Details
6. Privacy & Signature
Share Name/Address?
Yes
No
Share Phone?
Yes
No
Share Email?
Yes
No
Digital Signature (Type Full Name)
Submit Official Application
