Missouri LICA Membership Application
Membership Type:
*
Contractor Membership
Company Associate Membership
Supporting Membership
Contact Name:
*
First Name
Last Name
Company Name:
*
Phone:
Please enter a valid phone number.
Cell Phone:
Please enter a valid phone number.
Email:
example@example.com
Maiing Address:
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
2nd Contact Name:
First Name
Last Name
2nd Contact Phone:
Please enter a valid phone number.
2nd Contact Email:
example@example.com
2nd Contact Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
3rd Contact Name:
First Name
Last Name
3rd Contact Phone:
Please enter a valid phone number.
3rd Contact Email:
example@example.com
3rd Contact Mailing Address:
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Spouse's Name:
First Name
Last Name
Missouri County:
Website (if applicable):
example@example.com
Birth Date:
-
Month
-
Day
Year
Date
Products/Services:
(Will be used for complimentary listing in the MLICA Annual Directory and web site - please limit to 75 words)
How did you hear about Missouri LICA?
*
Work Categories (check all that apply):
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Concrete/Hardscaping
Crane Service
Directional Boring
Drainage/Water Mgmt./ Irrigation
Earthmoving/Grading/Land Leveling
Excavating/Land Clearing
Gravel/Rock/Sand Production
Landscaping/Seeding/Sod
Open Ditch Work/Dredging
Ponds/Dams
Roads/Paving
Site Prep./Demolition
Septic Systems/Onsite Wastewater Treatment
Trucking/Hauling
Terraces/Waterways
Underground Utilities
Equipment (Check all that apply):
Backhoe
Crawler Loader
Crane
Dirt Pan
Dragline
Dozer
Dump Truck
Excavator
Grader
Hydraulic Dredger
Land Plane
Loader
Marine Equipment
Scraper
Skid Steer
Trencher
Terms of Membership
*
Company Associate Terms
*
Please verify that you are human
*
Payment by Credit Card
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Contractor Membership
Any person engaged in owning and operating construction equipment in the field of land improvement . A contractor membership includes membership in a state district; the state chapter; the National Land Improvement Contractors of America (National LICA), and the National LICA Region IV.
$
350.00
Auxiliary Membership
Any spouse of a LICA member. The Auxiliary membership fees support the scholarship fund, as well as Auxiliary activities.
$
15.00
Company Associate Membership
Any person, firm or corporation dealing in materials, equipment or services incidental to the land improvement industry, but not eligible for a contractor membership.
$
300.00
Supporting Membership
Any person genuinely and sincerely interested in the furtherance and promotion of sound land improvement practices; any sales person of an associate member dealing in the sale of materials, equipment or services incidental to the land improvement; and any contractor over the age of 70.
$
75.00
Credit Card
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