|PECA Membership Application|
|City State Zip|
|Business Entity||Individual Partnership Corporation|
|Business Started (Mo./Date/Yr.)|
|Years In Present Business Form|
|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
- Check all items you
are licensed for.
|Corrosion Protection System Analyst|
|List two (2) existing PECA member companies' names you feel would sponsor your application.|
|I would like to be considered for participation on the following committees.|
|List qualifications or expertise you posses that would enhance this Association.|
|Type or Print Name|
and Mail To:
PECA P.O. Box 1502 Sparta, NJ 07871
Phone: 973.729.2108 FAX: 973.726.0661
Do not send a check with this application. Upon your acceptance, a letter will be sent to you along with a prorated dues' bill.
Thank you for your desire to join the Petroleum Equipment Contractors Association of New Jersey.