APPLICATION FOR ASSOCIATE STATUS TO THE
DEFENSE INDUSTRY OFFSET ASSOCIATION (DIOA)

(Name of Sponsoring Company)	hereby requests to sponsor
(Name of Company to be sponsored for Associate Status)	for Associate status in the “DIOA” as described in the Articles of Association.

The under-signed representative of the company requesting Associate status hereby certifies that this firm:

is organized or chartered under the laws of the United States

has its principal place of business in the United States

is significantly engaged in the sale of defense equipment or defense-related services

manufactures its equipment in or has its services originating substantially from the United States

is a first-tier subcontractor to a DIOA member company and is a party directly or indirectly to offset agreements established with foreign governments

is not engaged in the sale or brokering of offset/countertrade services

is not owned or controlled by a foreign government

is not controlled by, under common control with and does not control another DIOA member.

The undersigned further confirms that he/she is authorized to sign this application.

For Associate Company:

Name:

Title:

Date:

Firm’s Address:

Signature:

Designated Point of Contact:

Title:

Telephone:

e-mail:

Sponsoring DIOA Member Company:

Signature:

Approved by Executive Committee:

Date:

Please email completed application back to Brian Casey, Chairman, DIOA Membership Committee, at caseyb@telephonics.com.