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ASSOCIATE MEMBERSHIP APPLICATIONAssociate Membership shall be open to any person, firm or corporation, public agency, county, city or educational institution, not actually engaged in the manufacture or production of hot mix asphalt. Associate Members should promote high business standards, practices and ethics. They should also promote the proper and efficient use of hot mix asphalt. Associate Members shall be entitled to all services from the Association including bulletins, newletters, seminars and technical support. In addition, Associate Members may attend all meetings of the Membership. (PLEASE PRINT LEGIBLY)APPLICANT Company / Individual Name:_______________________________________________Mailing Address:_______________________________________________Physical Address (if different)_______________________________________________Phone:_______________________________________________Fax:_______________________________________________E-Mail Address:_______________________________________________Web Site:_______________________________________________AUTHORIZED REPRESENTATIVEName:_______________________________________________Title:_______________________________________________FIRMS ACTIVITYBriefly indicate the nature of your business. (i.e. aggregate producer, asphalt refiner, equipment manufacturer, bonding company, etc.)____________________________________________________________________________Signed:_______________________________________________Title:_______________________________________________Date:_______________________________________________ASSOCIATE MEMBER CATEGORY AND DUESAssociate membership is divided into 6 categories.Membership dues are payable annually. The fiscal year of WAPA begins January 1.No initiation fee is required, but annual dues are payable in advance.Members joining after July 1 will be assessed 50% of the annual dues. Thereafter, their bill will be on a regular full year basis.Each Associate member has one vote on the Associate Members’ Council.The Associate members’ Council will elect a Chair who will serve for 2 years.The Associate members’ Council Chair will have one voting seat on the WAPA Board of Directors.Membership dues include sponsorship of Annual and Mid year WAPA social functions. Credit for this sponsorship will be acknowledged at each event.CATEGORIES OF ASSOCIATE MEMBERSHIPPlease circle the applicable Associate Membership Category for your company. Major Asphalt Refiner / Supplier Associate – Annual Dues $5,000 (Annual gross asphalt sales in WA State over $5 Million)Supporting Asphalt Refiner / Supplier Associate – Annual Dues $2,500 (Annual gross asphalt sales in WA State under $5 Million)Major Associate – Annual Dues $1,500 (Annual gross asphalt related sales in WA State are over $5 Million) Manufacturers and/or distributors of Plant and Equipment. Aggregate suppliers, Asphalt Paving Contractors (non producers) etc.Supporting Associate – Annual Dues $1,200 (Annual gross asphalt related sales in WA State are under $5 Million) Manufacturers and/or distributors of Plant and Equipment. Aggregate suppliers, Asphalt Paving Contractors (non producers), etc.Sustaining Associate – Annual Dues $1,000 Supports the HMA Industry (financial, insurance, bonding, legal, pavement breakers and millers, stripers, traffic control, trucking companies, testing companies, consultants, etc.Individuals / Educational Institutions / Public Agencies – Annual Dues $500EDUCATIONAL / COMMUNITY INVOLVEMENTPlease list any activities / involvement that your company has in your community and/or schools, etc.____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________APPLICATION PROCEDURESubmit this application, with all information complete.MAIL APPLICATION TO:WASHINGTON ASPHALT PAVEMENT ASSOCIATION724 Columbia St NW #245OLYMPIA, WA 98501Phone (360) 539-7804Fax (360) 539-7964NOTE: The Washington Asphalt Pavement Association (WAPA) and the National Asphalt Pavement Association (NAPA) are cooperative but separate organizations. If you would like an application form for NAPA please check this box. ................
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