Missouri LICA Membership Renewal

Thank you for renewing your support of Missouri LICA!

Please update any contact information, as needed.

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:

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):

Equipment (Check all that apply):

Terms of Membership *

Company Associate Terms *

Payment by Credit Card

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

Subtotal

$ 0.00

Tax

$ 0.00

Total

$ 0.00

Credit Card