Download Part 2 - Distribution Contractors Association

Member World Federation of
Pipeline Contractors Associations
DISTRIBUTION CONTRACTORS ASSOCIATION
Application for Industry Membership
Membership Requirements Annual Dues $375
not deemed eligible for Regular or Associate membership by the Board of Directors. An Industry Member may
as selected by the Board of Directors. The Board of Directors may establish or change the procedure to be
followed in approving such applications.
Name: _____________________________________________________________________________________________________
Firm Name: ________________________________________________________________________________________________
Mailing Address: ____________________________________________________________________________________________
City: _____________________________________________ State: ________________________Zip: ________________________
Physical Address: ___________________________________________________________________________________________
City: _____________________________________________ State: ________________________Zip: ________________________
Telephone: _________________________________________ Fax:___________________________________________________
E-mail: ______________________________________________ Web site: _____________________________________________
Names of any DCA Members known by applicant:
_____________________________________________________ _____________________________________________________
_____________________________________________________ _____________________________________________________
Why are you considering membership with DCA?:
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
____________________________________________________________________________________________________________
Do you plan to attend DCA events? Yes No Maybe
Would you consider serving on a DCA committee? Yes No Maybe
I have read the DCA Statement of Purpose, and upon
becoming an Industry-at-Large Member, agree to adhere
to its tenets.
__________ _________________________________
(Date) (Signature and Title)
Method of payment upon Board of Directors’ Approval:
Invoice Credit Card Amex MasterCard Visa
CC# _________________________________ Exp. ______________
Print and Mail, E-mail or Fax Completed Application to:
Distribution Contractors Association
101 W. Renner Rd., Suite 460 Richardson, Texas 75082
Phone: (972) 680-0261 Fax: (972) 680-0461 www.dcaweb.org membership@dcaweb.org
132 dcaweb.org