One Industry's Waste is Another Industry's Raw Material ----- If YOU are not Recycling then YOU are THROWING IT ALL AWAY !!!!

     Maine Materials Exchange

Helping Maine Industry Minimize Waste through Industrial and Commercial REUSE and RECYCLING

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 Patron/Associate

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Guest
Patron/Associate

 

Appendix ID - Registration Form       

I wish to Register as a:

First Name
Initial
Last Name
Title
Affiliation

Has your business ever registered with M2X before? o Yes o No

If yes! Do you know your Associate ID#  or Patron ID #?  IF you have previously registered your organization with the Maine Materials Exchange and know your Associate or Patron ID# 

Enter it here   or   I have previously registered but

IF registered as an Associate or Patron you need not fill in any further information unless something has changed. 
IF you registered as a Quest ---- please continue.

Address-PO Box
Address-Street
City
State/Prov.
Zip / PCode
Country
Type of Business
S.I.C. code
Telephone
Extension
FAX
Toll Free #
E-mail
(optional info)

Web Site

Mobile / Cellular #
2nd Contact  First Name
Initial
2nd Contact  Last Name
2nd Contact  Title
Telephone
Extension
Number of Employees

 

This Company/Organization/Individual wishes to be:

A Subscribing Associate  A Non-Subscribing Patron

For listing / exchanging commodities via the M2X WebSite/Newsletter and/or submitting for sale, donation, exchanging commodities and/or purchasing, exchanging commodities via the Warehouse.

Wishes to be considered as:   (check all that apply.)

A Buyer   A Broker  A Dealer  A Recycler/Re-user  A Non-Profit

For making purchases or participating in exchanges from the M2X Newsletter and/or the M2X Warehouse Facility.

The organization's Maine State Sales Tax Number is:

This Company/Organization/Individual has participated in one or more of the following Waste Minimization/Source Reduction/Pollution Prevention Programs: (check all that apply.)

 

WasteCap Assessment Program     ECM-CTT Assessment Program                 Me. DEP Pollution Prevention Program  Uof Me. Industrial Assessment Program  Any other waste minimization/source reduction/P2 program  (please specify)

In the box below, please disclose any Environmental Regulatory Actions

current  pending, or   past

which involve commodities which might be offered for sale or exchange via the Maine Materials Exchange.

Release Agreement:

The undersigned (by pressing the submit button) acknowledges to having read and agree to the terms of the DISCLAIMER and furthermore agrees to release M2X and its staff, sponsors, directors and advisors from any claim, liability, obligation, or responsibility resulting from, pursuant to, or connected to the listing of materials or any other matter related to the Maine Materials Exchange.

e-mail address:  

Submitted this Date:

For Assistance completing this form or for other information, Call M2X @ 207-865-6621

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Copyright 2000 Maine Materials Exchange
Last modified: February 18, 2000