Fillable 2021 Membership Application (Electrical Association)

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2021 Membership Application (Electrical Association)

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PRODUCT SERVICE MEMBERSHIP $335
2021 Membership Application
Company: _____________________________________
Designated Contact: _____________________________
License #: _____________________________________
Address: ______________________________________
City/State/Zip: __________________________________
Phone: ________________________________________
Cell Phone: ____________________________________
Fax: __________________________________________
Email: _________________________________________
Web Site: _____________________________________
Referred by: ___________________________________
How did you hear about us? _______________________
Do you have managers at BRANCH locations who would
also like to receive the newsletter? Scroll to the next page
and enter that information. This is an “Aliate” member-
ship with an additional dues fee.
NEW MEMBER INFORMATION:
Accounting
Attorney
Business Services
Distributor
Equipment
Fuel / Fleet
Information Technology
Insurance
Manufacturers
Manufactuers Reps
Rebates
Recyclers
Schools
Utility Coops
Other ____________________________________
YOUR AREA OF SPECIALIZATION:
WHICH MEMBER BENEFITS INTEREST YOU THE MOST?
Yealry Dues: $335 + Aliate Memberships from pg 2 if applicable ($_____________) = Total $_____________
Check enclosed Credit Card (Visa, Mastercard, AmEx)
Credit card #: ________________________________________________________________________________________
Exp. Date: __________ Security Code:__________ Name on Card: _____________________________________________
Enroll in autopay (dues will be drafted from your credit card on file annually)
Billing Address (if different than above):
Bill
ENCLOSE PAYMENT WITH APPLICATION:
Return your membership application with payment:
Product Service Membership is for companies who provide products and services to the electrical industry.
Examples of product service members include, but are not limited to, distributors, manufacturers, manufacturing
representatives, schools, utilities, accountants, attorneys, builders, remodelers, architects (AIA), engineers, and
equipment rentals companies.
Opportunities to host events and classes. Welcome
contractors personally. Your company name will be
promoted on the invitation, in the newsletter, and at
the event.
Product / Service Council. Tell us how we can
better serve your needs.
Opportunity to join a committee. Develop personal and
business relationships.
Free link from our website to yours
Opportunity to serve on the Board. One product
service member serves as a non-voting member of the
Board of Directors. Develop business relationships with
leaders in the industry.
Association newsletters and government action alerts
Discounts on advertising in the newsletters and online
Free listing in the Quick Resource Guide
Free 8 hrs Association code class for you or one of your
clients
MAIL
3100 Humboldt Ave S
Minneapolis, MN 55408
EMAIL
info@
electricalassociation.com
PHONE
612-827-6117
800-829-6117
FAX
612-827-0920
Description of your company / what products / services do you oer for electrical contractors? (This will be printed on the Quick
Resource Guide with opportunity to change every 6 months). 75 words or less please. _____________________________
____________________________________________________________________________________________________
____________________________________________________________________________________________________
PAGE 2
-
AFFILIATE MEMBERSHIP
2020 Membership Application (cont.)
Company: _____________________________________
Designated Contact: _____________________________
License #: _____________________________________
Address: ______________________________________
City/State/Zip: __________________________________
Phone: ________________________________________
Fax: __________________________________________
Email: _________________________________________
Web Site: _____________________________________
NEW AFFILIATE MEMBER INFORMATION
WHICH OF YOUR MEMBERSHIP BENEFITS INTEREST YOU THE MOST?
Number of Aliate memberships ________ x $85 = $___________ (Enter this total on page 1 above.)
ENCLOSE PAYMENT WITH APPLICATION:
Aliate Membership is only for employees of member companies. The membership stays with the company.
Employees of member companies enjoy the benets of the Association; however, they choose to have their own aliate
membership to receive the newsletters. A common example includes branch locations of member companies.
Opportunities to host events and classes. Welcome
contractors personally. Your company name will be
promoted on the invitation, in the newsletter, and at
the event.
Product / Service Council. Tell us how we can
better serve your needs.
Opportunity to join a committee. Develop personal and
business relationships.
Newsletters and government action alerts
Opportunity to serve on the Board. One product
service member serves as a non-voting member of the
Board of Directors. Develop business relationships with
leaders in the industry.
Discounts on advertising in the newsletters and online
Free link from our website to yours
1
2
3
Company: _____________________________________
Designated Contact: _____________________________
License #: _____________________________________
Address: ______________________________________
City/State/Zip: __________________________________
Phone: ________________________________________
Fax: __________________________________________
Email: _________________________________________
Web Site: _____________________________________
4
Company: _____________________________________
Designated Contact: _____________________________
License #: _____________________________________
Address: ______________________________________
City/State/Zip: __________________________________
Phone: ________________________________________
Fax: __________________________________________
Email: _________________________________________
Web Site: _____________________________________
Company: _____________________________________
Designated Contact: _____________________________
License #: _____________________________________
Address: ______________________________________
City/State/Zip: __________________________________
Phone: ________________________________________
Fax: __________________________________________
Email: _________________________________________
Web Site: _____________________________________
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2021 Membership Application (Electrical Association)

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Completed 17 July 2021

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