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PAINTING AND DECORATING CONTRACTORS OF AMERICA<br />
1801 Park 270 Drive <strong>•</strong> Suite 220 <strong>•</strong> St. Louis, MO 63146<br />
Toll Free: 877-500-7322 <strong>•</strong> Fax: 314-514-9417 <strong>•</strong> Web: www.pdca.org<br />
Prospective Member Information Form<br />
PDCA is a “UNIFIED” membership federation. Prospective members must join a Chapter and/or Council upon joining at the National level,<br />
except in cases of remote geography. To learn more about PDCA, local Chapters, Councils and Specialty Forums, please call membership<br />
services at 877-500-PDCA (7322) or fax/mail back this prospective member information form to the address above. Please take a few moments<br />
to complete this prospective member information form as fully and legibly as possible. All the information you provide is strictly confidential.<br />
Company Name: _______________________________________________________________________________________________________<br />
❑ Mr. ❑ Mrs. ❑ Ms. ____________________________________________________________________________________________________<br />
Title/Position: __________________________________________________________________________________________________________<br />
Mailing Address: ________________________________________________________________________________________________________<br />
City, State, Zip: _________________________________________________________________________________________________________<br />
Phone: _____________________________________________________ Fax: ______________________________________________________<br />
E-Mail: _____________________________________________________ Company Website: __________________________________________<br />
Date company was organized: _______________ Business License/Federal Tax ID#: _________________________________________________<br />
Primary Industry Category: Annual Sales Volume:<br />
❑ Residential<br />
❑ Commercial<br />
❑ Industrial<br />
❑ Decorative<br />
First Name M.I. Last Name<br />
Check Annual Sales<br />
One Volume<br />
❑................Up to $499,999<br />
❑................$500,000 - $2,999,999<br />
❑................$3,000,000+<br />
Annual dues vary based on the size of your company and the addition of Chapter, Council<br />
and Specialty Forum dues. Annual dues start at just over $1 per day.<br />
Signature _______________________________________________________________________ Date: _________________________________<br />
Recruited By (If Applicable): _______________________________________________________________________________________________<br />
Recruiter Company: _____________________________________________________________________________________________________<br />
I would like more membership information regarding: _________________________________________________________________________<br />
To learn all about PDCA membership<br />
Call us today at 877-500-7322 or visit www.pdca.org
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