Membership Application 9 2014docx .pdf

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CONTRACTORS RESOURCE CENTER
MEMBERSHIP APPLICATION
Date:

______
Annual Membership Fee: $150

Firm Name:
Firm Address:
City:

State:

Zip Code:

Primary Contact:
Business Phone:

Cell Phone:

Email:

Services/Product Provided:

Commercial Contracting License?

□ Yes



No

Bonding Capacity: $

□ Yes □

Are you a member of the Alliance of Minority Contractors?
Are you a member of any other Trade Association?

□ Yes

No

□ No

If yes, which one? ________________________________________________________________________
Is your firm currently DBE certified?

□ Yes

□ No

If no, are you eligible for certification?

Please list any other current certification(s), including certifying agency(ies):
__

Relevant Experience
Project:
Scope Performed:
Contract Value:
Project:
Scope Performed:
Contract Value:
Project:
Scope Performed:
Contract Value:

Client:
Date Completed:
Client:
Date Completed:
Client:
Date Completed:

CONTRACTORS RESOURCE CENTER
Membership Application

What type of technical assistance/training does your firm need: (Check all that apply)
 Estimating
 Business Financials
 Financing/Loan Packaging
 Bonding/Insurance
 Computerized Accounting (Quickbooks) Training
 Back Office Assistance
 Project Management
 Marketing
 Contract Review
 Other: ____________________________________________________________________________
Additional Information: (Please share any additional information about your firm’s qualifications/experience or attach
a Capability Statement.)

________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
________________________________________________________________________________________
_____________________________________________
Applicant’s Signature

_____________________________________
Date

Completed form may be submitted via email to wbrc@urbanleagueneworleans.org
________________________________________________________________________________________________
Internal Use Only:
 Membership Approved
 Membership Not Approved
 Annual Membership Fee Paid

Date: _________________________

Notes:________________________________________________________________________________________
_____________________________________________________________________________________________
_____________________________________________________________________________________________
________________________________________________________________________________________________
The Urban League of Greater New Orleans reserves the right to refuse membership to any applicant. All information submitted is subject to verification.

Urban League of Greater New Orleans  Contractors Resource Center
4640 S. Carrollton Ave. Suite 250 New Orleans, LA 70119  (504) 620-9647


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