Date: ________________
| Full Name of Company:_____________________________________________ | ||
| Address:_________________________________________________________ | ||
| Address:_________________________________________________________ | ||
| City: _________________________________ State: ___________________ Zip:______________ | ||
| Phone:_________________________ Fax: ________________________ | ||
| Website URL: ______________________________________________ | ||
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| Names, titles of partners, officers, managers, and number of years in industry | ||
| 1________________________________________________________________________________ | ||
| 2________________________________________________________________________________ | ||
| 3________________________________________________________________________________ | ||
| 4________________________________________________________________________________ | ||
| Length of time company has been in business:___________________________________________ | ||
| Company's primary business (type of work done): _______________________________________ | ||
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| Letter of recommendation from 3 SEICA members who sponsor your application for membership. | ||
| Sponsor Name | Company Name | |
| 1_________________________ | ___________________________ | |
| 2_________________________ | ___________________________ | |
| 3_________________________ | ___________________________ | |
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| List name or names as they will appear in Membership Book and for Roll Call, and seica.org | ||
| Member Name | Member email address | Member Spouse Name |
| __________________________ | __________________________ | __________________________ |
| __________________________ | __________________________ | __________________________ |
| __________________________ | __________________________ | __________________________ |
| __________________________ | __________________________ | __________________________ |
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Dues and Fees: Enclose a check payable to SEICA in the amount of $325.00. This includes the first year's dues ($300.00) and the initiation fee ($25.00). Mail to: Dee Gowen, SEICA, P.O. Box 11242, Knoxville, Tn 37939 |
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