Altoona Builders Exchange

APPLICANT FIRM:
MAILING ADDRESS: (Street, PO Box, RRD)
CITY:
STATE:
ZIP + 4:
PHYSICAL ADDRESS: (Street, RRD)
CITY:
STATE:
ZIP + 4:
TELEPHONE #:
FAX #:
WATS #:
E-MAIL ADDRESS:
WEB SITE ADDRESS:
FIRM PRINCIPAL: (Full Name):
TITLE:
CONTACT PERSON/SALE REP: (Full Name):
TITLE:
PRIMARY CONSTRUCTION TRADE SPECIALTY:
OTHER TRADE SPECIALTIES:
DATE PRESENT BUSINESS STARTED:
AVERAGE # OF EMPLOYEES:
FINANCIAL & TRADE REFERENCES:
Annual and Other Type Billings Should Be Forwarded To: (Check One)
Applicant Firm
Other (Below)
COMPANY NAME:
ADDRESS: (Street, PO Box, RRD)
CITY:
STATE:
ZIP + 4:
Mail Member Copy of “The Builders Bulletin” To: (Check One)
Applicant Firm
Other (Below)
INDIVIDUAL’S ATTENTION:
ADDRESS: (Street, PO Box, RRD)
• MEMBERSHIP FEE: (please check one)
• Level One: $485.00 Annual Membership, Paid In Advance
• Level One: $270.00 Six-Month Membership, Paid In Advance
• Level Two: $1085.00 Annual Membership, Paid In Advance
• Level Two: $600.00 Six-Month Membership, Paid In Advance
There will be a $100 activation fee added to all new membersips and memberships that have lapsed longer than six months.