Independent Electrical Contractors

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About IEC

Legislative

Member Services

Contractor Membership

Contractor Membership Application

The applicant for Contractor membership in the Association, shall be a legally licensed contractor engaged in the Electrical Construction Industry, or the Voice/Data/Communications Industry, in an area served by this Chapter. The applicant agrees to participate in the Chapter's programs, support the stated purposes of this Association and pay dues, fees and assessments when due. An initiation fee of $250.00 and the first month's dues must accompany this application.

Application - Adobe PDF (.pdf) Format

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Company Name:

Address:

City:

State:
Zip:

Phone:

Fax:

Corporation Officers Or Owners

Name:

Title:

Address:

Name:

Title:

Address:

The Master Electrician for this firm is
This person is licensed in the city of
Their Current license number is and expires
The individual who will represent this company is
The Alternate Representative is

References

Electrical Contractor:

Address:

Phone:

Electrical Contractor:

Address:

Phone:

Supplier:

Address:

Phone:

Supplier:

Address:

Phone:

Supplier:

Address:

Phone:

Supplier:

Address:

Phone:

Membership shall be continuous. In the case of termination, all dues shall be paid in full as of that date, and I agree to discontinue immediately the use of the Association insignia in any form. Termination requests must be made in writing. This application is subject to approval of the Board of Directors. I authorize investigation of all statements contained herein and certify they are true and correct and hereby make application for contractor membership.

Signed by

Title

Date

You may submit this form electronically in order that we may begin processing this application. However, IEC must receive an original signed copy of the application (you may print this page) and payment of applicable fees prior to approval of the application by the Board of Directors.