b'MRCA Membership Application The undersigned company hereby applies for the following class of membership in MIDWEST R NG CONTRACTORS ASSOCIATION, INC. OOFIoACTIVE MEMBERSHIP - Any established roofing contractor in the United St that is engaged in the application of roofing, waterproofing, ates sidinginsulation. or oASSOCIATE MEMBERSHIP -Any person or firm with an interest in the busin and affairs of thisiation,(1) manufacturers and essassoc except: suppliers of materials andused by the Active Memb of thisand ( roofing contractors eligible formembership in the productsersassociation;2)active association. OSUSTAINING MEMBERSHIP - A MRCA Memberseligible to become Sustaining Members by m annt in MRCA overabove llareakinginvestme and ""their annual membership dues.fied by theewill be allocated to su the activities of the MUnless otherwise speci member, th investmentpportRCA ro theIncTechnical and Research Committee, the MRCA Applicator Agreement Review P gram, andMRCA Foundation,. MRCA dues are 100 percent deductiblean ordinary and necessary business expense - no portion- MRCA dues is alloc to lobbying expen .asofableditures However, the IRS req us tothat contributionsgifts to MRCA are not deductible as charltable contributions for Federal Income Tax purposes. uiressayor If you are applying for Associate Membership, please describe your interest in the business andof this: affairsassociationKey Contact ____::\';::__- -~~- ~-\'-,,-Spouse\'s Name-,- ___;_____ _Company Name Address~~- -:-\',-____.__ ____._ .,.-o-_ _c\': ~-~- ~- ~- - - - - -_ -City,,.,,. ;; ,,;-\': - :-:-=\'-T-~ _ - -T ._ -~ -,~;-; - ~ elephone ::- Establishment Fax #- ,,,.-.,,~ -Date of E-mailWeb site~ ~ -=~ - ,- -~ ame ofRepr(lsentatives: Applicant\'s 1 - -~ =\':+-+- ~Spouse_~-,\'-\'-\'"\' - "- :,-. - _~ ~2.Spouse_.,.,.~ ~ - ~~-~ - ~~- -Please indicate the markets you are involved in: oBuilt-UpO Modified Bitu ,oSingle~P oStandingoM l men iySeametaoSteepoSidingoInsulationoWaterproofingO Other 0PVCO EPDMoDampproofing"oCold Adhesives OGutters and DownspoutsOSkylights and Roof Windows0Interior Remodelin,QoVentilating oUnionoNon-UnionAre you aof the National Roofing,Contr iation?oYesoNo memberactors AssocSignature - - - - -~- ,,-,-_ _Title_______ _ _ ___ _ _______ _DateSponsored By____ ____ _ _________Annual Dues: For current a al du investm t am our automated F -on-Dem dtem ataoonoB-6459. nnu esen ount, callax an sysMethod of~ Payment:0CheckOMoney OrderOVISAOMastercardOAMEX Card_ ___ _ ___ _ _ _ _ _ _ _ _ ___~ Exp._ _____ _ _ _ ____ ___ No.Date Name on CardAuth Signature _ ____ _ _ ___ _ _ _ _ ____ orized Return with Payment to:MIDWEST ROO NG C ACTORS AS TION,015th Street, Suite 1000,rence,66049-3862 FI ONTR SOCIA 484 W.Law KS Toll Free: 800 -6722785/843-4888Fax: 785/843-7555 /497'