Member Application 2 ABC Carolinas Membership Application – Offline Pay Step 1 of 8 12% Company InformationCompany Name(Required)Business Address(Required) Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Mailing Address Mailing Address is THE SAME as the Business Address Mailing Address is DIFFERENT than the Business Address Mailing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code (if different)Phone(Required)Website Individual / Contact InformationName(Required) First Last Primary Contact Title:Primary Contact Email(Required) Primary Contact Phone(Required)Primary Contact Mobile Phone(Required)Primary Contact Mailing Address Primary Contact’s mailing address is THE SAME as the business / mailing address Primary Contact’s mailing address is DIFFERENT than the business / mailing address (if different):Primary Contact Mailing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Secondary Contact Name First Last Secondary Contact TitleSecondary Contact Email Secondary Contact PhoneSecondary Contact Mobile Phone Membership Categories Associate Member Category: Includes professional service firms ie: banks, insurance, law firms, architects, engineers, and other specialty service firms. Supplier Member Category: Includes construction material suppliers/ Contractor Member Categories: Includes general contractors, construction managers, prime contractors and subcontractors. Dues are based on previous year’s construction volume in North and South Carolina. Payment Schedule: Dues are payable for one year in advance at time of enrllment. Thereafter, dues are billed and payable each January, less appropriate pro-rated credit for new members.My business is a: Non-Contractor Contractor Please indicate the type of business you representNon-Contractor MembershipAssociate MemberSupplier MemberContractor MembershipContractor: $1 – $500,000Contractor: $500,001 – $1 MillionContractor: $1 Million – $3 MillionContractor: $3 Million – $6 MillionContractor: $6 Million – 10 MillionContractor: $10 Million – $20 MillionContractor: $20 Million – $50 MillionContractor: $50 Million – $100 MillionContractor: $100 Million – $250 MillionContractor: Over $250 Million Type of Work ServicesType of Company Supplier Associate Type of Company General Contractor Specialty Contractor Company Ownership Status DBE MBE SDBE SDVOSB VOB WOSB 8A Other Number of Field EmployeesNumber of Office EmployeesNumber of Fleet VehiclesIn Business SinceyyyyCSI Division or NAICS and Trade Codes Engagement and BenefitsPlease check the reasons for joining or are interested in learning more about: Apprenticeship Business Development / Networking Continuing Education Committees & Councils Discount Programs Free Enterprise Government Affairs / Local & State Politics Leadership & Management Legal Advice Safety-Related Training School 2 Career Programs Young Leader Program (FLEX) Other Other InterestsSponsor An ABC Staff Member Another Business / Person Please tell us who told you about ABC or encouraged your firm to join ABC Carolinas?Staff RecruitPlease list the name of the ABC Carolinas staff representativeSponsor NameSponsor Company / FirmSponsor Email Additional ContactsWorkforce Development ContactWorkforce Development Contact Email Workforce Develoment Contact PhoneAccounting ContactAccounting Contact Email Accounting Contact PhoneSafety ContactSafety Contact Email Safety Contact PhoneSocial Media HandlesTwitterLinkedInInstagramFacebook Branch LocationsBranch LocationsBranch Address (Street, City, State, Zip)Branch Contact (Name)Branch EmailBranch Phone Add Remove CheckoutTotal Membership Fee to be charged How Would Yo Like To Pay? Online with Credit Card Offline Invoice and Check Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20242025202620272028202920302031203220332034203520362037203820392040204120422043 Security Code Cardholder Name Billing Address Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Billing Email Billing Phone 75332
