WorkersFirst - Membership Application

Membership Application

Please fill out this form or print and return with payment to the
ARSM-HACCA
4314 Eagle Point Parkway
Birmingham, Alabama 35242

Questions? Call us at 205.981.0086 or 800.239.4744.

* Membership Type:	Contractor Associate
* Company Name:
* Submitted By:
Title:
Mailing Address:
City:
State:
Zip Code:
* Street Address (if different):
* City:
* State:
* Zip Code:
* Designated Representative:
* Alternate Representative:
Gross Annual Sales:
Phone:
Fax:
* Email:
Web Site Address:
Type of Business:
I apply for membership in the Alabama Roofing, Sheetmetal, Heating and Air Conditioning Contractors Association and agree, if accepted, to abide by the Bylaws of the Association.

Contractor Membership Dues:

Gross Annual Sales Dues

$0 - $500,000 $250/year

$500,001 - $1,000,000 $300/year

$1,000,001 - $2,000,000 $350/year

$2,000,001 and over $400/year

Associate Member Dues:

NOTE: The Association’s fiscal year begins January 1.

Make Check Payable to:
ARSM-HACCA
P.O. Box 381236
Birmingham, Alabama 35238-1236

* required field