Download Part 2 - Distribution Contractors Association

DISTRIBUTION CONTRACTORS ASSOCIATION
Member World Federation of
Pipeline Contractors Associations
Membership Requirements
turing
or selling materials, supplies, insurance, bonds, services, or
equipment for the construction or maintenance of distribution
pipelines, cable, and duct systems may apply for Associate
Membership in the Association. Applications for all Membership
Application for Associate Membership
Firm Name: ________________________________________________________________________________________________
Mailing Address: ____________________________________________________________________________________________
City: _____________________________________________ State: ________________________Zip: ________________________
Physical Address: ___________________________________________________________________________________________
City: _____________________________________________ State: ________________________Zip: ________________________
Telephone: _________________________________________ Fax:___________________________________________________
E-mail: ______________________________________________ Web site: _____________________________________________
If a corporation, list name cers:
_____________________________________________________ _____________________________________________________
_____________________________________________________ _____________________________________________________
If individual or partnership, name of owners or partners:
_____________________________________________________ _____________________________________________________
_____________________________________________________ _____________________________________________________
Name: ______________________________________________ E-mail: ________________________________________________
Title: ________________________________________________ Phone: _______________________________________________
Name: ______________________________________________ E-mail: ________________________________________________
Title: ________________________________________________ Phone: _______________________________________________
used in distribution or pipeline operations.)
_____________________________________________________ _____________________________________________________
_____________________________________________________ _____________________________________________________
_____________________________________________________ _____________________________________________________
_____________________________________________________ _____________________________________________________
_______________________________________________________
Printed name
_________________________________________________
Company
I have read the DCA Statement of Purpose, and upon
becoming an Associate Member, agree to adhere to its tenets.
__________ _________________________________
Invoice Credit Card Amex MasterCard Visa
CC# _________________________________ Exp. ______________
Print and Mail, E-mail or Fax Completed Application to:
Fax: www.dcaweb.org membership@dcaweb.org
131 dcaweb.org