Associate Affiliate Membership: Mid-Year / Half-Price
Associate Affiliate Definition: Any company that is a vendor or supplier of a service or product for the utility construction industry. This includes sales of products or services to the industry. This does not include any company who performs contracting services on a job site. Please view the type of work drop down designations below for some examples. Membership dues are currently half price and will cover membership for the remainder of the year.
Date
*
-
Month
-
Day
Year
Date
Type of Membership
*
Please Select
Associate Affiliate (AA)
Type of Work
*
Please Select
Accounting Services
Aggregates
Auctioneers
Equipment Dealers
Fleet Vehicle Services
Financial Services
Insurance Services
Legal Services
Pipe/Utility Supplies
Precast/Concrete Products
Pumps
Shoring
Truck Parts/Trailers/Tires
Other:
Type of Work (Other):
Please Note: ONLY use this section if you selected 'Other' under type of work. Please do not list brands or long descriptors.
Company Name
*
Address
*
Street Address
Street Address Line 2
City
State
Zip Code
Company Phone
*
-
Area Code
Phone Number
Website
Main Contact
*
First Name
Last Name
Title
E-mail
*
example@example.com
Cell Number
-
Area Code
Phone Number
Additional Contacts
Recruited By GUCA Member:
Full Name
Company
Associate Annual Sales Volume / Mid-Year Dues Amount
*
prev
next
( X )
$0-$2 Million Annual Volume
$
400.00
$2-$5 Million Annual Volume
$
600.00
Over $5 Million Annual Volume
$
750.00
Total
$
0.00
Signature
*
Signature date
*
Enter the message as it's shown
*
Submit
Print Form
Should be Empty: