NORTHEAST FLORIDA ROOFING AND SHEET METAL

              CONTRACTORS ASSOCIATION, INC.

       2012 Membership Renewal/New Member Application

On behalf of the NEFRSA, I would like to take this opportunity to invite you
to join or renew your NEFRSA membership.  This is your trade’s professional association in
Jacksonville. The success of the NEFRSA and of each business represented will be attributed
to the donation of time, talent, and resources of each member to bring our industries to a
higher level of professionalism and to leave to the next generation of Roofing and Sheet Metal
Contractors the hope of fulfilling their own dreams.

Please provide the following information on the lower portion of this page.  Due to the uncertain
economictimes, the Board of Directors this year has provided for remittance of dues in half years
increments if youwish to do so.
 
On behalf of the Board of Directors, thank you for your continued support and participation. 
We look forward to seeing you at the next meeting.

Respectfully submitted:

Ralph DeCicco, President

Member Type (check one): ____New member or  ____ Renewal

Contractor Membership                            Associate Membership

___Roofing  ___Sheet Metal  ___Builder   ___Vendor   ___Manufacturer     ___Other

Regular...…$135.00                                                

Silver……...$165.00  Includes a link to your company web site.

Gold…….....$270.00  Includes a 2-page custom designed members homepage.

Platinum..  $300.00  Includes a link to your company web site & 2-page custom designed homepage.

(Those choosing a membership level that includes web services will be contacted by our Webmaster.)

Company name: __________________________________________________________ 

Address: _________________________________________________________________ 

Phone #: ________________  Fax #: ________________  Cell #:__________________      

E-mail :_______________________________  website:___________________________

License('S) # ______________________________________________________________

Company contact: _____________________  Contact birth month:________________

Preference to receiving communications (please choose one): _____e-mail         _____fax       

Committees on which you would be willing to serve: __________________________________

Please remit your check and this form to: NEFRSA 

                                                                      P.O. Box 10124

                                                                      Jacksonville, FL 32247-0124