COUNCIL OF INDUSTRIES
P.O.
PT.
94807
APPLICATION FOR MEMBERSHIP
ADDRESS: ___________________________________________________________
___________________________________________________________
___________________________________________________________
TELEPHONE: ___________________________________________________________
FAX: ___________________________________________________________
E-MAIL: ___________________________________________________________
DESCRIPTION OF
FIRM’S BUSINESS: (Annual
report, company brochures, etc. may be attached).
____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
__________________________________________________________________________________________
NAMES, TITLES,
EMAIL ADDRESSES OF COMPANY REPRESENTATIVES:
(Monthly
agendas will be e-mailed to names listed).
__________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
NUMBER OF
EMPLOYEES IN
ASSESSED
VALUATION FOR MOST RECENT TAX YEAR: _________________________
TITLE:
_______________________________________________________ DATE: _____________________