A. GENERAL INFORMATION

Business Name

Contact E-Mail Address

Owners

Last Name: First Name:

Last Name: First Name:

Last Name: First Name:

Physical Address

Address:

City: State: ------------------ Idaho Montana Washington ------------------ Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming ZIP:

Mailing Address (check if same as physical address)

Address:

City: State: ------------------ Idaho Montana Washington ------------------ Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming ZIP:

B. NAHB STATISTICAL INFORMATION

Number of Employees:

Annual Dollar Volume: ------------------ Under $500,000 $500,000 to $1,000,000 $1,000,000 to $5,000,000 $5,000,000 to 10,000,000 Over $10,000,000

Number of Homes Built Annually:

C. BUSINESS REFERENCES

Reference 1

Last Name: First Name:

Address:

City: State: ------------------ Idaho Montana Washington ------------------ Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming ZIP:

Phone:

Reference 2

Last Name: First Name:

Address:

City: State: ------------------ Idaho Montana Washington ------------------ Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming ZIP:

Phone:

Reference 3

Last Name: First Name:

Address:

City: State: ------------------ Idaho Montana Washington ------------------ Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington Washington D.C. West Virginia Wisconsin Wyoming ZIP:

Phone:

MEMBERSHIP TYPE

Builder Membership

Builder membership in the Panhandle Building Contractors Association is available to any person who is, or has been in the business of building or rebuilding homes, apartments, schools, commercial, industrial, or other structures, normally related and essential to a community or in land development, and who subscribes to the National Association of Home Builders Code of Ethics (See NAHB Code of Ethics here) and is of good character and business reputation.

Associate Membership

Membership Dues for Builder Membership is $400.00

Dues are renewable once a year on your anniversary month.

Associate Membership

Associate Membership in the Panhandle Building Contractor Association is available to any person engaged in a trade, industry or profession related ot the building industry, and who subscribes to the National Association of Home Builders Code of Ethics (See NAHB Code of Ethics here) and is of good character and business reputation.

Associate Membership

Membership Dues for Associate Membership is $400.00

Dues are renewable once a year on your anniversary month.

Select Membership Type:

Business Membership Associate Membership

Oath

I agree to abide by the Constitution and By-Laws of the Panhandle Building Contractors Association to which this membership application is directed, and to the National Association of Home Builders of the United States with which it is affiliated, and of the Idaho Building Contractors Association with which is is also affiliated. I also agree that if mediation is needed, that I will follow the guidelines set forth by the American Arbitration Association.