Company NameCorporation Type Sole Proprietorship Partnership Corporation Street Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Is Mailing Address the same as Street Address? Yes, the same No, different Please add Mailing AddressMailing Address Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code PhoneFaxEmail Name and Title of Authorized Representative(s):NameTitleNameTitleNameTitleNameTitleNature of business (please be specific as to the type of products/services offered):The above named company hereby makes application for affiliate membership in the Utah Mechanical Contractors Association. Through this application, the undersigned agrees to all bylaws and articles of incorporation of the Utah Mechanical Contractors Association. The undersigned further approves the annual dues of the Utah Mechanical Contractors Association in the amount of $350.00 This approval shall be effective on the date of this application, and thereafter until the amount of said dues is modified in accordance with the bylaws and articles of incorporation of the Utah Mechanical Contractors Association. Check enclosed for $350.00 for first year of affiliate membership. Please make payable to the Utah Mechanical Contractors Association, 669 South 200 East, Salt Lake City UT 84111-3800. Signature of Company OfficialDate of Application MM slash DD slash YYYY For more information, please contact the UMCA office at (801) 364-7768.
