Institute of Food Technologists 525 W. Van Buren, Suite 1000 Chicago, IL 60607 Application for Membership Phone: +1.312.782.8424 Fax: +1.312.782.8348 [email protected] Please fill out the information below and submit it with payment. If you are a full-time student, complete IFT’s Student Membership Application online at ift.org. Please print legibly. Referred by ______________________________________________________________________________________________________________________________________________________________ Referring Individual’s Company Name ___________________________________________________________________________________________________________________________________ Referring Individual’s State/Province _____________________________________________________________________________________________________________________________________ Referring Individual’s Section (if applicable) ______________________________________________________________________________________________________________________________ General Chef Doctor Professor Rabbi Other _______________________________________________________________________________________________________ Information First Name ______________________________________ Middle Initial ________ Last Name __________________________________________________________________________ Preferred First Name_________________________________________________________________________________________________________________________________________ Your preferred mailing address: Home Business Address _____________________________________________________________________________________________________________________________________________________ City ___________________________________________ State _________ ZIP/Postal Code _____________________ Country _____________________________ Phone: Mobile ____________________ Home ____________________ Business __________________________ Email _________________________________________ How did you hear about IFT? Email Colleague Digital Ad Social Media Mail Internet IFT Event School Other _____________________________________________________________________________________________________________________________________________________ Were you previously an IFT Student Member? Yes No Have you ever been a member of IFT? Yes No In what year did/will you enter the profession ________________________________ In which job segment are you currently employed? Academia Government Industry Retired Student Demographic Date of Birth ______ / ______ / _________ (dd/mm/yyyy) Information Gender Identity: Male Female Non-binary/third gender (does not identify with male or female) Information is optional and for demographic purposes only Not listed (please specify)______________________ Prefer not to answer Current Organization/Company _____________________________________________________ Department/Division ____________________________________________________________ Employment Position/Title ______________________________________________________________ Start Date (Month/Year) ______________________________________/ Address/P.O. Box _____________________________________________________________________________________________________________________________________________ City _______________________________________________ State __________ ZIP/Postal Code _______________________ Country _________________________________________ Office Phone ___________________________________________________________ Fax ____________________________________________________________ Email __________________________________________________________________________________________________________________________________ Highest College/University ____________________________________________________ Field of Study ______________________________________________________________________ Degree Degree ______________________________________________________________ Graduation Date (Month/Year) ______________________________________/ You qualify for a Premier Membership early career discount if you graduated within the three years prior to completing this application. Qualifying members receive a discounted price on Premier Membership during the first three years following graduation, with all the same benefits as full Premier Members. Please do not attach additional material, such as a résumé, publication list, or recommendation letter to this application. We appreciate your cooperation. Page 1 of 4 Employment Demographics Please check your business affiliation. Select one category. Academic Institution (07) Food Mfg./Processor (01) Instrumentation Mfg./Supplier (19) Scientific/Trade Assn./Foundation Beverage Mfg./Processor (16) Food Safety Svcs./Equip. Mfg./ Packaging Equip. Mfg./Materials (13) Consulting (06) Supplier (18) Mfg./Supplier (04) Services for the Food Industry (20) Contract Processing/Packaging (05) Foodservice (09) Private Research Institution (08) Student (17) Food Ingredients/Flavors Mfg./ Government (10) Processing Equip. Mfg./Supplier (03) Other (14) Supplier (02) Independent Testing Lab (11) Publisher (12) What segment(s) listed below apply to your company/business? (Check all that apply.) Bakery Products (05) Foodservice (15) Non-GMO (16) Snack Foods (09) Beverages (08) Fruits/Vegetables-processed (03) Organics (19) Sugar/Confectionary/ Dairy Products (02) Grain Mill/Cereal Products (04) Pet Foods (14) Candy Products (06) Fats & Oils (07) Meat/Poultry/Seafood Products (01) Prepared Foods/Dinners/Entrees (13) Vegetarian/Vegan/Plant Based (18) Food Ingredients/Additives (12) Naturals (17) Produce-Fresh (11) Other/Not Applicable (10) Please select your primary work function/job title. Check the one category that best describes your job. R&D/Scientific/Technical Vice President – R&D Scientific- Product/Brand Manager (26) Teaching-Research (36) Chemist (08) Technical (01) Sales Representative (27) Technical-Scientific (35) Dir. of Research/Development (02) Other R&D-Scientific-Technical (16) Technical Sales Representative (29) Other Education (40) Dir. of Technical Services (03) Vice President (23) Flavorist (09) Management/Supply Chain Other Sales & Marketing (30) Consultants Food Engineer (10) Engineering/Processing Dir./Mgr./ Management (42) Supvr. (20) Food Scientist/Technologist/ Purchasing Technical/Scientific (41) General Manager (19) Product Developer (11) Purchasing Agent-Buyer (32) Other Consultants (43) Plant Manager-Supervisor (21) Laboratory Director (07) Purchasing-Procurement Dir./Mgr./ President-Owner-Partner-Officer (17) Microbiology (12) V.P. (31) Government Quality Control-Dir./Mgr./Supvr. (51) Nutrition (13) Other Purchasing (33) Inspection (46) Quality Control-Entry Level (52) Packaging (14) Management-Administrative (44) Vice President Quality Assurance – Entry Level (05) Education/Academia Post Doctoral Researcher (50) (not R&D-Sales & Marketing) (18) Quality Assurance Dir./Mgr./Supvr. Administrative (34) Research (45) (04) Other Management (22) Extension (38) Other Government (47) Research Chef (06) Management (37) Sensory Evaluation (15) Sales & Marketing Post Doctoral Researcher (53) Other Job Title/Function Broker (28) Student (39) Other (48) Director (24) Manager (25) Please indicate the areas in which you have buying influence, i.e., select/approve, determine/specify, or purchase. (Check all that apply) Ingredients Flavor Potentiators (23) Processing/Packaging/Laboratory Services for the Food Industry Acidulants (01) Flavors (22) Equipment, Instrumentation Additive/Ingredient Analysis (45) and Supplies Anticaking Additives (02) Fruits & Vegetables (fresh/dehyd/ Analytical Testing Service (46) Chemical/Ingredients Analyzers (42) Antifoaming Additives (03) freeze-dried) (24) Computer Equipment/Software/ Food Packaging Equipment/Systems Antimicrobial (04) Gums/Hydrocolloids (25) Systems (61) (38) Antioxidants (05) Maltodextrins (26) Contract Processing/Packaging (47) Food Packaging Materials/Supplies Meat/Poultry/Fish/Seafood (27) Education/Information Services (48) Bakery Product Ingredients (06) (39) Natural Colors (64) Foodservice Product/Process Dev Bases/Mixes/Stocks (07) Food Processing Equipment/ (49) Batters/Breadings (08) Nuts (28) Systems/Supplies (36) Govern. Regulatory/Inspection/R&D Botanicals (65) Pasta Products (29) Food Processing Instrumentation (37) Svcs. (50) Bulking Agents (09) Probiotics (68) Lab Equipment/Supplies (44) Management/Marketing Consulting Proteins/Protein Products (30) Cannabis (66) Microorganisms Detection Kits (41) (53) Spices/Seasonings/Salt (31) Cereal Grains (10) Physical Property Measuring Package Development/Design (54) Starches (32) Instruments (40) Certified Colors (13) Personnel Recruitment/Placement Cheeses/Cheese Products (11) Sweeteners (33) Sensors & Internet of Things (IoT) (59) (67) Cocoa/Chocolate Products (12) Vitamins/Minerals/Nutrient Process Development (52) Supplements (34) Temperature/Humidity/Water Confection Ingredients (14) Product Development (51) Yeasts/Yeast Products (35) Activity Instr. (43) Dairy Product Ingredients (15) Publications/Books (55) Emulsifiers (16) Quality Assurance/Control (56) Encapsulated Ingredients (17) Regulatory/Legal Consulting (57) Enzymes (18) Sensory Evaluation (58) Fat Replacers (19) Site Selection/Economic Fats & Oils (20) Development (60) Fiber & Prebiotics (21)