Membership Application

For consideration to apply with the El Paso County Roofing Association, please fill out the form below to apply.

Become a Member

Instructions

Business Name

Type of Member

Website Address (URL)

Phone

Fax

Years in the Roofing Business

Years in El Paso County

Number of Employees

Physical Address

Apt, suite, etc.

Country

City

State

Zip code

Mailing Address (if different than physical)

Apt, suite, etc.

Country

City

State

Zip code

Contact Name

Contact Title

Contact Phone

Contact Email

Regional Building License Number

Type of License

Insurance Agent Name

Insurance Agent Phone

Workman's Comp Policy Number

Liability Policy Number

Submit a Current Insurance Certificate

TRADE / SUPPLIER REFERENCE LIST (PLEASE LIST 3)

Company 1 Name

Company 1 Contact

Company 1 Phone

Company 1 Email

Company 1 Address

Apt, suite, etc.

Country

City

State

Zip code

Company 2 Name

Company 2 Contact

Company 2 Phone

Company 2 Email

Company 2 Address

Apt, suite, etc.

Country

City

State

Zip code

Company 3 Name

Company 3 Contact

Company 3 Phone

Company 3 Email

Company 3 Address

Apt, suite, etc.

Country

City

State

Zip code

BANK REFERENCE

Name

Contact

Phone

Address

Apt, suite, etc.

Country

City

State

Zip code

CONTRACTOR - CLIENT REFERENCE (PLEASE LIST 3)

Client 1 Name

Client 1 Contact

Client 1 Phone

Client 1 Email

Client 1 Address

Apt, suite, etc.

Country

City

State

Zip code

Client 2 Name

Client 2 Contact

Client 2 Phone

Client 2 Email

Client 2 Address

Apt, suite, etc.

Country

City

State

Zip code

Client 3 Name

Client 3 Contact

Client 3 Phone

Client 3 Email

Client 3 Address

Apt, suite, etc.

Country

City

State

Zip code

ASSOCIATION INFORMATION

Please list three (3) items that you would envision the El Paso County Roofing Association doing for your company:

Item 1

Item 2

Item 3

Please list three (3) items that you would be willing to do to help build a strong roofing association:

Item 1

Item 2

Item 3

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