application-for-membership

Application for Membership

Firm Name:

Mailing Address:

City

State:

Zip

Phone:

Email

Web Site:

Official representative for purposes of voting and holding elected office in the HDDA.

Name:

Email:

Title

Phone:

Other person(s) to receive official HDDA coorespondence:

Name:

Email:

Title

Phone:

Name

Email:

Title:

Phone:

Number of years in the Horizontal Directional Drilling Industry:

Year Established:

Number of Years:

Geographical Areas Served:

Number of Employees:

Types of Services Provided:

Type 1

%

Type 2

%

Type 3

%

Type 4

%

Type 5

%

Type 6

%

HDDA Member Referral (List two (2) active members of the Association) (Optional)

1. Name:

Title:

Company:

2. Name:

Title:

Company:

List available industry specific companies which work has been performed in the Horizontal Directional Drilling Industry, in the past three (3) years.

1. Company:

Contact:

2. Company:

Contact:

3. Company:

Contact:

If accepted to membership, we agree to abide by the By-Laws of the HDDA:

Name

Title

Date

Annual Dues Amount Owed $

(Amount based on the below revenue chart)

Estimated HDD related Annual Revenue

Present Year Annual Dues
$750
$1000
$2500
$3500
$4500
$6000

Upon membership approval by the Board of Directors, Applicant dues can be submitted via check or Credit Card.

Please be advised that information contained in this application is strictly confidential and will only be used by the Board of Directors in consideration of the applicant for membership to the HDDA.