Become a Member

Date of Application*

Name*

First M. I. Last

Title

If Other was selected, specify Title here:

Email*

Phone*

Company Name*

Fax*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Membership Section

Indicate by selecting the best responses below that identify what your company's main construction category is.

Membership Type*

Business Activity*

Builder Member Classification

Select the most important business activities from the list of codes below.

Associate Member Classification

Associate Members - select the most important business activities from the list of codes below.

Associate Member - Retail Dealers/Distributors

Retail Dealers/Distributors ONLY, select field

Associate Member - Subcontractors and Specialty Trade Contractors

Subcontractors and Specialty Trade Contractors ONLY, select field

Associate Member - Wholesale Dealers/Distributors

Wholesale Dealers/Distributors ONLY, select field

Associate Member Classification "Other"*

If Other was selected in any of the Associate Member categories above, please specify "Other" here

Builder and Associate Members, complete as is applicable

# of Employees*

Enter the total paid employees, include the member in the total figure.

$ Volume*

Approximate Annual Dollar Volume of new residential construction/development

# Units*

Approximate Annual Number of residential units built in the last 12 months

References (Optional)

Did a current member tell you about Cedar Valley HBA?*

If yes, who?

Applicant Signature