IECTP Online Membership Form

IEC of the Texas Panhandle

702 S. Madison

Amarillo, TX 79101
Application for Regular or Associate Membership Please Circle: Regular/ Associate Instructions: Please complete this form in its entirety. The primary contact must sign the Attestation of this form in order to be considered for membership.

Frim Name *

Street Address *

City *

State *

Zip *

Phone Number *

Please list any and all names of Owner(s), Parttner(s) or Officer(s) of corporation *

Persons Authorized to represent the firm in IEC activities:

Primary Contact Name *

Primary Contacts Title *

Phone Number *

Secondary Contact Name

Secondary Contacts Title

Phone Number

FIRM PROFILE

Year Founded *

Number of Employees *

Which classification best describes your firm? *

A. Residential Contractor

B. Commercial Contractor

C. Industrial Contractor

ATTESTATION
The firm hereby makes application for membership in the IEC and certifies that the foregoing statements are correct; that it will be governed by the Articles of Incorporation and Bylaws IEC. In becoming a member of IEC, I/we agree to support the IEC in its mission.

Electronic Signature *

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Membership type *

Associate - $175 Initiation Fee + $600 Annually

Contractor - $175 Initiation Fee + Dues Structure (see below)

IEC DUES STRUCTURE

Monthly Dues:

The following dues structure is effective February 18, 2016. It is based on the number of field electrical employees only. Do not include office staff.

Tax Implications of Membership:

9.25% of your total dues are used for lobbying Expenses and therefore non-deductible as a Business expense for Federal Income Tax Purposes.

$16 of your total dues is used for the IEC Insights Publication.

Number of electrical field employees employed on an average monthly basis *

Number of Foremen employed on an average monthly basis *

Number of Journeymen employed on an average monthly basis *

Number of Apprentices employed on an average monthly basis *

Authorized Signature *

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