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International Membership Application

International membership is available to any organization outside the United States and its territories. Please fill out separate membership application(s) if your membership is to include facilities and/or offices other than at the below address.

If you do not wish to submit this form online, you can also print out this form and mail, email or fax it to:
National Safety Council
1121 Spring Lake Drive
Itasca, IL 60143 USA
Fax: +1-630-285-1434

Organization Name:* 
Primary Contact First Name:* 
Primary Contact Last Name:* 
Primary Contact Title:* 
Primary Contact E-mail Address:*   
Street Address 1(for package shipments):* 
Street Address2:  
Zip/Postal Code:*
Website Address: 
Total Number of Full-time Employees:* 
If applicable, Total Number of
Drivers included in Full-Time Employee Count:
Type of Facility:

Please check here if you prefer not to receive:

Members of the National Safety receive many benefits. Click here to read more about the many benefits you’ll receive.

International Membership dues are USD $750.00/year/location.

Payment Options

Along with submitting your application, please arrange U.S. funds payment via one of these payment options.
Payment must accompany this online application.

Check/Money Order payable in U.S. funds to International Safety Council.
Checks submitted to U.S. Headquarters must be drawn on U.S. bank.