ANNUAL DUES: $190.

00

JOHNSON COUNTY BUILDERS ASSOCIATION

P. O. BOX 2331
CLEBURNE, TEXAS 76033
817-556-0062
APPLICATION FOR MEMBERSHIP
Type of Membership (Circle One): Builder/Remodeler

Subcontractor

Referred by: __________________________________________

Membership (Individual or Company):

_______________________________________________

Company Representative:

______________________________________________________

Type of Business:

______________________________________________________

Address:

______________________________________________________
Street (P.O. Box)
City
State
Zip

Telephone Number(s)

______________________________________________________
Office
Cell
Fax

________________________________________
Email
Number of years in business: ______

____________________________________
Companys website
Location: _________________________________

__________________________________________________________________________________
REQUIRED FOR MEMBERSHIP
NAMES, ADDRESSES AND PHONE NUMBERS OF BUSINESS REFERENCES:
1. _________________________________________________

)________________________

2. _________________________________________________

)________________________

3. _________________________________________________

)________________________

The undersigned applicant states that the information is true and accurate as of this date, and
acknowledges that membership in the Johnson County Builders Association is contingent on the validity
of such information. The undersigned applicant agrees to abide by the Code of Ethics and By-Laws of
the Association.
________________________________________
Signature
Date: ___________________________

____________________________________
Printed Name