Peace River Construction Association

Box 6954, Peace River, AB T8S 1S7

PH 780-624-5351 FAX 780-624-0929

Email prca5351@telus.net

MEMBERSHIP APPLICATION

DATE____________________

We the undersigned hereby make application for membership in the Peace River Construction Association , an organization of General Contractors, Trade Contractors, Manufacturing and Supply firms, and other Industries and Services, allied to the Construction Industry, with all the rights and privileges pertaining thereto.

We conform to and are governed by the Constitution, By-Laws, Agreements, and Regulations of the Association now in force or to any alterations which are made by proper authority during such membership

We attach our cheque for $700.00 GST included to cover dues for a Membership for the period of January 1, 2011 to December 31, 2011 inclusive.

PLEASE NOTE: We do not accept Visa, Master Card or Debit. We apologize for any inconvenience this may cause.

NAME OF FIRM:_________________________________________

STREET/MAILING ADDRESS:_______________________________

CITY:________________________POSTAL CODE_______

PHONE:______________ FAX__________________

NATURE OF BUSINESS:___________________________________

WEB SITE:____________________EMAIL_____________

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Signature

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Printed Name