Indiana Construction Roundtable Membership Application

"The mission of the Indiana Construction Roundtable, Inc., is to improve the quality and cost effectiveness of the construction and major maintenance industries, thereby enhancing a facility's ability to provide added economic value to its organization"

Dues and fees applicable through December 31, 2008

You will be INVOICED for this membership.
If you would prefer to print the application and send a check, please follow this link.

Name & Contact Information

Name of Organization
Primary Contact for ICR
Contact Name
Title
Business Mailing Address
Street Address
City
State
Zip/Postal Code
Phone number
Fax Number
Email Address

Note: ICR uses multiple forms of communication to provide notification to members regarding a variety of industry information as well as specific ICR programs and other information that may benefit its members. If there are additional people in your organization that would benefit from this information, please list their name and email address below. Should the space provided be insufficient, please fax (317-328-2545) or email (scrist@miccs.org) the additional names to Susan Crist.

Name	Email Address

Membership Categories and Dues

Note: ICR's membership year follows the calendar year. Members join by paying for a full year, regardless of the month in which they join. Renewal invoices will be due January 1 of each year and will be prorated, providing credit for months for which new members paid but did not receive services (e.g., companies joining in June will be invoiced for 50% of the dues amount on their first renewal invoice).

Select your membership Category (please check the appropriate box)
Owner (Consumers of Construction Services)			Contractors
	Public Entity	$1,000		Volume, up to $10 million	$1,000
	Private, up to 250 Employees	$1,000		Volume, over $10 million	$1,500
	Private, over 250 Employees	$1,500
Affiliates
	All	$1,000

Were You Referred to ICR?

Yes	No	If yes, please provide the following:
Individual's Name:
Company Name: