Download printable PDF or use form below

Application for Membership
Company Name:

Primary Contact:

Title:

Mailing Address:

City: State:

Shipping Address:

City: State:

Phone Number:

Fax Number:

E-Mail Address:


Date:


Website Address:
Type of Business:
Years in Business

Notification Preference
Fax E-mail (for memos, plan notifications, etc.)

Category:

Referred By: (name)
Referred By: (company)
Please have your insurance carrier fax us a copy of your liability and workers compensation certificate.

Dues for all categories of membership are $250 billed annually. Dues will be pro-rated at the time of joining the Association according to the schedule below.

Month
Amount
September
October
November
$250
$230
$210
Month
Amount
December
January
February
$190
$170
$150
Month
Amount
March
April
May
$130
$110
$90
Month
Amount
June
July
August
$70
$50
$30

A remittance of $ representing my annual membership dues in Tri-State Area Contractors Association, Inc.
Check
Please charge to my Mastercard/Visa

The undersigned agrees that upon acceptance of membership by the Board of Directors of the Tri-State Area Contractors Association, Inc., he/she will endeavor to abide by the bylaws of the Association. Our mission is to further the interests of the local construction industry, while at the same time providing a safe work environment for employees and the general public. We further strive to cultivate working relationships with local government agencies, community leaders, architects, and engineers. Fulfillment of this mission is pivotal to the development of our community.

Signature: