MEMBERSHIP APPLICATION
( ) ACTIVE CONTRACTOR/CONSULTANT $300
Any person, firm, or corporation or agent thereof, a part of whose business is the application of commercial or industrial insulation and/or asbestos abatement. 2 Representatives per company.
General Abatement Contractor ___________ Restoration Company __________
Consultant ___________ Other General Contractor _____________
( ) DISTRIBUTOR/ASSOCIATE/AFFILIATE $250
Any firm, partnership, corporation or agents thereof, a part of whose business is the manufacture and sale of materials, products, equipment or services for commercial or industrial insulation or asbestos abatement, or whose business is concerned with the insulation/asbestos removal/abatement distributor-contractor industry. 2 Representatives per company.
Distributor __________ Service/Training Provider ________
School District __________ City/Town___________ Hospital __________
( ) INDIVIDUAL MEMBERSHIP ________$50/Yr.
Individual Membership does not give individual vote. It provides for a representative vote.
COMPANY__________________________________________________
ADDRESS __________________________________________________
____________________________________________________________
TELEPHONE ________________________________________________
FAX _______________________________________________________
EMAIL _____________________________________________________
YEARS IN BUSINESS _________________________________________
REPRESENTATIVES (2) _______________________________________
____________________________________________________________
Officer/Title _______________________________________________
SIGNATURE ________________________________________________
NEW MEMBER: IF JOIN AFTER JANUARY, PRO-RATED DUES PAID FOLLOWING YEAR. EXAMPLE: JOIN IN JULY, PAY $300; FOLLOWING YEAR, PAY $150 JANUARY 1 FOR YEAR.
Pay with Paypal! Click Here then click on Send Money