WorkersFirst - Membership Application

Membership Application

Please fill out this form or print and return with payment to the
Workers First
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