PHCC - National Association 2017 At-Large Membership Application
Best People. Best Practices.™
PHCC - National Association 2017 At-Large Membership Application Dues Amount:
Primary Contact: Contact Name:
Full Active Member - $515 USD
_ (Person to receive PHCC-National Association mailings)
*Introductory Member - $258 USD
Title:
* Available only to contractors that have never been members of PHCC. st 1 Year Introductory Member dues are 50% of Active Member dues. nd 2 Year Introductory Member Dues are 75% of Active Member dues. rd 3 Year – must convert to Active Member status. Introductory members receive full benefits – except they may not vote, hold office or propose bylaw amendments.
Company Name: Mailing Address: City:
State:
Phone:
Zip: Fax:
E-mail: Method of Payment: Amount: $ _ Check/Money Order (payable to PHCC) Visa MasterCard American Express Card #: Exp.: /_ Membership dues may be deductible as a business expense, but not as a charitable contribution. For 2017, PHCC estimates that 5% of your national dues constitute Lobbying expenses.
Note: *Dues are billed on a calendar year basis and will be prorated depending on join date. Money Back Guarantee: If you’re not 100% satisfied with your PHCC-National membership anytime in the first year, we will refund your membership investment.
Primary Type of Work – Select One:
Referral Types of Work – Select all that apply:
Type of Shop – Select all that apply
A/C / Backflow / Drain Cleaning / Energy Efficient
A/C / Backflow / Drain Cleaning / Energy
Dual / Union / Open / Minority Owned
Heating / Indoor Air Quality / Plumbing / Radiant
Efficient Heating / Indoor Air Quality / Plumbing
Woman Owned / Veteran Owned
Heat / Water Filtration / Solar Heat / Water Efficiency / Fire Sprinklers / Generators
/ Radiant Heat / Water Filtration / Solar Heat / Water Efficiency Fire Sprinklers / Generators
Primary Field of Work – Select One:
Other Fields of Work – Select all that apply:
Number of Employees:
Residential Ser. & Repair / Comm. Ser. & Repair
Residential Ser. & Repair / Comm. Ser. &
Less than 6 / 6 – 10 /
Residential Remodel / Comm. Remodel
Repair Residential Remodel / Comm. Remodel
11 – 20 / 21 - 40 / 40+
Res. New Construction / Comm. New Construction /
Res. New Construction / Comm. New
Institutional / Industrial
Construction / Institutional / Industrial
Date Business Founded:
Volume of Annual Business:
Volume of Products Purchased Annually:
Certifications:
Less than $500k / $500k - $750k / $750k - $1M
Less than $500k / $500k - $750k / $750k - $1M
NATE / BPI / LEED /
$1M - $2.5M / $2.5M - $5M / $5M - $8M /
$1M - $2.5M / $2.5M - $5M / $5M - $8M /
Energy Star Credentialed / Water Auditor
$8M - $15M / $15M - $25M / $25M - $40M / $40M+
$8M - $15M / $15M - $25M / $25M - $40M / 0M+
Backflow / Energy Auditor
180 S. Washington St Ste 100 │ Falls Church, VA 22046 │ P: 703-752.8100 │ T: 800-533-7694 │ F: 703-237-7442 │ www.phccweb.org
Company Membership Roster As an active member of PHCC, all of your employees have access to the member benefits as well. Please list all employees in your company that should have access to member benefits. Job Title Role/Responsibilities First Name
Last Name
Examples: CEO, HR, Estimator, Technician
Email Address **Each employee must have a unique individual email address and cannot begin with info@, office@ and etc.
1: 2: 3: 4: 5: 6: 7: 8: 9: 10: 11: 12: 13: 14: 15:
180 S. Washington St │ Suite 100 │ Falls Church, VA 22046 │ P: 703-237-8100 │T: 800-533-7694 │ F: 703-237-7442 │ www.phccweb.org
PHCC - National Association 2017 At-Large Membership Application Dues Amount:
Primary Contact: Contact Name:
Full Active Member - $515 USD
_ (Person to receive PHCC-National Association mailings)
*Introductory Member - $258 USD
Title:
* Available only to contractors that have never been members of PHCC. st 1 Year Introductory Member dues are 50% of Active Member dues. nd 2 Year Introductory Member Dues are 75% of Active Member dues. rd 3 Year – must convert to Active Member status. Introductory members receive full benefits – except they may not vote, hold office or propose bylaw amendments.
Company Name: Mailing Address: City:
State:
Phone:
Zip: Fax:
E-mail: Method of Payment: Amount: $ _ Check/Money Order (payable to PHCC) Visa MasterCard American Express Card #: Exp.: /_ Membership dues may be deductible as a business expense, but not as a charitable contribution. For 2017, PHCC estimates that 5% of your national dues constitute Lobbying expenses.
Note: *Dues are billed on a calendar year basis and will be prorated depending on join date. Money Back Guarantee: If you’re not 100% satisfied with your PHCC-National membership anytime in the first year, we will refund your membership investment.
Primary Type of Work – Select One:
Referral Types of Work – Select all that apply:
Type of Shop – Select all that apply
A/C / Backflow / Drain Cleaning / Energy Efficient
A/C / Backflow / Drain Cleaning / Energy
Dual / Union / Open / Minority Owned
Heating / Indoor Air Quality / Plumbing / Radiant
Efficient Heating / Indoor Air Quality / Plumbing
Woman Owned / Veteran Owned
Heat / Water Filtration / Solar Heat / Water Efficiency / Fire Sprinklers / Generators
/ Radiant Heat / Water Filtration / Solar Heat / Water Efficiency Fire Sprinklers / Generators
Primary Field of Work – Select One:
Other Fields of Work – Select all that apply:
Number of Employees:
Residential Ser. & Repair / Comm. Ser. & Repair
Residential Ser. & Repair / Comm. Ser. &
Less than 6 / 6 – 10 /
Residential Remodel / Comm. Remodel
Repair Residential Remodel / Comm. Remodel
11 – 20 / 21 - 40 / 40+
Res. New Construction / Comm. New Construction /
Res. New Construction / Comm. New
Institutional / Industrial
Construction / Institutional / Industrial
Date Business Founded:
Volume of Annual Business:
Volume of Products Purchased Annually:
Certifications:
Less than $500k / $500k - $750k / $750k - $1M
Less than $500k / $500k - $750k / $750k - $1M
NATE / BPI / LEED /
$1M - $2.5M / $2.5M - $5M / $5M - $8M /
$1M - $2.5M / $2.5M - $5M / $5M - $8M /
Energy Star Credentialed / Water Auditor
$8M - $15M / $15M - $25M / $25M - $40M / $40M+
$8M - $15M / $15M - $25M / $25M - $40M / 0M+
Backflow / Energy Auditor
180 S. Washington St Ste 100 │ Falls Church, VA 22046 │ P: 703-752.8100 │ T: 800-533-7694 │ F: 703-237-7442 │ www.phccweb.org
Company Membership Roster As an active member of PHCC, all of your employees have access to the member benefits as well. Please list all employees in your company that should have access to member benefits. Job Title Role/Responsibilities First Name
Last Name
Examples: CEO, HR, Estimator, Technician
Email Address **Each employee must have a unique individual email address and cannot begin with info@, office@ and etc.
1: 2: 3: 4: 5: 6: 7: 8: 9: 10: 11: 12: 13: 14: 15:
180 S. Washington St │ Suite 100 │ Falls Church, VA 22046 │ P: 703-237-8100 │T: 800-533-7694 │ F: 703-237-7442 │ www.phccweb.org
