Arkansas HVACR Association

Membership Application

Applicant’s Name: _____________________________________

Applicant’s Home Address: _____________________________

City: ______________________ State: ____ Zip: _______

Phone: ( ) ____________________ Fax: ( ) _____________

Email: _______________________________________________

Firms Name: _________________________________________

Firms Address: _______________________________________

City: _____________________ State: ____ Zip: ________

Phone: ( ) ____________________ Fax: ( ) _____________

Web Site: ____________________________________________

How long has your organization been involved with the HVACR Industry? _____

Number of Employees: _____

Number of Employees that carry a Contractor license? _____

Principal Business of your organization:

__ Architectural __ Distributor __ Educational

__ Electrical __ Engineering __ Factory Rep

__ Manufacturing __ Publishing __ Utility

__ Retailer/Dealer __Energy/Management

__ Service Organization __ Other

State Membership Dues are $120.00 annually. Each chapter have their own dues.

Associate Membership Dues are $200.00 annually, which gives you membership in each local chapter.

Applicant’s Signature: ____________________ Date: _______

Please mail application along with your check to:

Arkansas HVACR Association

P.O. Box 1296

Little Rock, AR 72203