Application for Additional Employee Membership

Company Name *

Applicant Name *

Address Line 1 *

Address Line 2

City *

State *

ZIP Code *

Country

Primary Phone *

Cell Phone

Email *

HBA Fox Cities Primary Member Representative (aka Member of Record for your Business) *

Have you ever been a member of Valley Home Builders Association / HBA Fox Cities? *NoYes (list year in the box to the right)

If yes, what year were you last a member?

Are you a current member of another home builders association (HBA)? *NoYes (list association in the box to the right)

If so, which association?

If you are/have been a member of an HBA, have you ever been suspended from membership? *NoYes (list association in the box to the right)

If so, which association?

If you are/have been a member of an HBA, have you ever been terminated from membership? *NoYes (list association in the box to the right)

If so, which association?

Have you owned, operated or done business under another company and/or personal name(s)? *NoYes (list name(s) in the box to the right)

If yes, please include names:

Reason for joining (check all that apply):

To belong to a professional organization/credibilityNetworking opportunitiesParticipate in public events (such as the Parade of Homes)Marketing opportunities - to membersMarketing opportunities - to consumersTo be listed in the online membership directoryAccess to members-only discount program/serviceOther (please list below)

Other:

Membership Dues PaymentPay via check (payments may be made to Home Builders Association of the Fox Cities, Attn: FAO, P.O. Box 12237, Green Bay, WI 54307-2237)Pay via credit card (payment field will populate below upon selection)Payment in full must accompany this application or it will not be processed.

Credit / Debit Card *

I, the undersigned, hereby apply for membership in the Home Builders Association of the Fox Cities (HBAFC). I agree to abide by the provisions of the Code of Ethics & Performance, Policies and Bylaws of the Association throughout the tenure of my membership (copies available upon request). I also agree to receive communications sent by or on behalf of HBAFC to the address, phone number and/ or email listed on this application. I understand that membership in HBAFC shall be effective upon submission of this completed application and tender of first year’s membership dues and applicable fees. If, after review of application, I am found ineligible for membership, a check for the dues amount will be returned to me via US Mail to the business address on this application; the application fee will be retained. I understand that membership is for 12 months and if I am 15 days delinquent on remittance of membership dues, I will be considered resigned. I also understand that if the Primary Representative/Member of Record is no longer a member of HBAFC, I am ineligible for membership as an Additional Employee, and that my membership will be automatically resigned (membership can be reinstated if Primary Rep renews and/or if I move into the Primary Rep position). In the event of resignation, suspension or termination of membership in HBAFC, I agree to immediately discontinue advertising my membership and use of the HBAFC logo in any form. I agree that in the event of voluntary or mandatory membership termination, HBAFC will not refund any proration of annual dues.

Applicant Signature *

Application for Additional Employee Membership

As a member of HBAFC, you become part of a group that invests in the construction trades and allied services. Support the industry that supports your business; please join us!

New Additional Employee Member Dues: $110

Reason for joining (check all that apply):