Petroleum Equipment
Contractors Association
of
New Jersey
APPLICATION FOR
MEMBERSHIP
Company Name
Mailing Address
City
State:
Zip:
Representative
Alternate Representative
Phone Number
Fax Number
Email Address
Web Site Address
Business Entity
Individual
Partnership
Corporation
Business Started (Mo./Date/Yr.)
Years In Present
Business Form
Active Membership Requirements
1) Business must be at least two
(2) years old, in its present form.
2) Requires sixty (60) percent of
revenues generated from the licensed items below.
Associate Membership Requirements
List Type Of Business
Relationship To Petroleum
Equipment
Installation Industry
Type Of Membership Requested
Active
Associate
Mfg/Rep
Active Membership -
Fill in all that applies. Use company License Number
Only.
NJ Weights & Measures Company
Only
License No.
NJ Underground Storage Tank
Certification
License No.
Installation - Check
all items you are licenses for.
Entire UST System
Release Detection Monitoring
System Only
Closure
Tank Testing
Substance Evaluation
Corrosion Protection System
Analyst
Cathodic Protection Specialist
Cathodic Protection Tester
Only
Sponsors
List two (2) existing PECA
member companies' names you feel
would sponsor your
application.
Sponsor #1
Sponsor #2
I
would like to be considered for participation on the following
committees.
Advertising
Education and Safety
NJ Government Affairs/B.U.S.T.
Membership
List qualifications or expertise
you posses that would enhance this Association.
Applicant's Signature
Type or Print Name
Date
Print Application
And Mail To:
Petroleum Equipment Contractors
Association of New Jersey
(PECA of NJ)
P.O. Box 100693
Fairfield, NJ 07004
Any questions,
feel free to call 973.882-0655. NOTE: Do not send a check
with this application.
Upon your acceptance, a letter will be
sent along with a prorated dues bill.
Thank you for your desire to join
The Petroleum Equipment Contractors Association