Membership Application

Company Name *

Street *

City *

State *

Zip *

First Name *

Last Name *

Email *

Phone *

Website

Would you like your website linked to HBA? *YesNo

Representative *

Title *

Number of Years In Business *

Number of Employees *

Primary Business *

HBA Sponsor *

Do you have any pending litigation against you? *YesNo

Check Yes for a free no obligation quote on your Worker's Comp Rating Cost. *YesNo

Provide your policy number *

The Board of Directors of the Association shall deliberate upon application for membership in this chapter after reviewing comments received from the membership. The Directors may restrict membership to those unwilling to adhere to a reasonable code, business and professional and ability to promptly pay dues.

If approved by the Board, the applicant shall be notified of the decision of the Board, and provide the applicant's representative with proper credentials and a copy of the By-Laws of the Association. Membership in this Chapter automatically carries with it membership in the Ohio Home Builders Association and the National Association of Home Builders.

Signature *

Date *

Month *

Day *

Year *

Criteria For Membership

Application for membership must be accompanied by a recommendation from an existing member of the association or an affliliate Home Builder Association.

Name *

Address

Phone *

Name *

Address

Phone *

List two (2) references from previous homeowners, customers or lot purchasers. Cannot be family, employees or principals of the company applying for membership.

All applicants are required to provide proof of insurance. *I agree to provide proof of insurance.

Are you a builder? *YesNo

Builder Criteria

Applicants must have been engaged in their own business for one (1) year prior to application for membership and must supply evidence of completion of his own business of at least.

A) Three (3) Dwelling Units

Or

B) Development of (6) building units

Or

C) Five remodeling projects of substantial nature

1. Address

2. Address

3. Address

4. Address

5. Address

6. Address

Two (2) references from material suppliers who are members of the Home Builders Association of Wayne and Holmes Counties or an affiliate Home Builder Association.

Name

Address

Phone

Name

Address

Phone

Annual Dollar Amount *Under $1 Million$1 - 5 Million$5 - $10 MillionOver $10 Million

Membership Identification

Membership TypeBuilder MemberAssociate Member

Single FamilyContractor

Multi-FamilyContractor

RemodelerResidential

OtherLand DeveloperMtg. Modular Homes

Associate Member

Retail Dealer / Distributors

Subcontractors & Speciality Trade

Wholesale Dealer Distributors

(Please Specify Other Associates)

ANNUAL DUES PAID TO THE HBA WILL ALSO INCLUDE MEMBERSHIP IN THE NATIONAL ASSOCIATION OF THE HOME BUILDERS & THE OHIO HOME BUILDER ASSOCIATION

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