Thank you for applying for the coveted APMA Certified American PPE Manufacturer seal. Please complete the form below and an APMA associate will be back in touch with you.
NOTE: Use of the APMA Certified American PPE Manufacturer seal without the consent of APMA is prohibited.

    Company Name

    Fed ID#

    FDA Registration #

    Product Listing#

    Corporate Address

    City

    State

    Zip

    # of Employees

    Representative Name

    Email

    Phone

    Representative Address

    Describe the products and services that you provide to the PPE industry for which you are applying to use the Certified American PPE Manufacturer seal.

    Product Description / Name:

    Product Description / Name:

    Product Description / Name:

    Product Description / Name:

    Product Description / Name:

    Are your employees all legally allowed to work in the United States? YesNo

    If NO please provide details as to why not.

    Does your Company have any offices outside the US? YesNo

    If yes provide details below and description of work done at these locations

    Does your Company import any parts or material from outside the US for final assembly of your finished product? YesNo

    If yes provide details below and description of work done at these locations

    List all locations where you manufacturer your product

    List all Providers of Raw Material & Their Address

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    List Any Third Party Assembly or Packaging Partners or Vendors

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    Provider Name
    Address

    Attach Quality Manual if Applicable

    Attach Brochure or Flyer

    Application fee is a one time membership due of $1,500.00
    NOTE: Applying companies must be a Corporate Member in order to apply.

    Application fees are non-refundable and do not guarantee that you will meet all criteria to qualify for use of the APMA American PPE Manufacturer Seal.
    Upon processing your payment an APMA team member will review your application and be in contact within 1-2 weeks.

    Please select method of payment:

    Credit Card Number

    CVV

    EXP Date

    Bank Account Number

    Bank Name

    First Name

    Last Name

    Middle Name

    Street Address

    City

    ST

    Zip

    Date