MEMBERSHIP ENROLLMENT FORM Membership Enrollment Form "*" indicates required fields Select Your Membership Type* Non-Industry - $500.00 (For roofing partners who are not in the construction industry: banks, attorneys, insurance, etc.) Roofing Contractor - $1,000.00 Associate Member - $500.00 (Remaining $500 due upon licensure, one year from membership date) Allied Partner - $1,500.00 License Number* Certification* Read more about the different membership classifications hereCompany Name Company Contact Name (mailings, newsletters, and association contact)* First Last Company Business Office Contact Name (renewals and memberships)* First Last Company Mailing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Contact Email* Contact Phone Number*Your receipt will be sent to this email address.Total Credit CardCard Details Cardholder Name Company Billing Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code CAPTCHA
