United Lightning Protection Association, Inc. 426 North Avenue ● Libertyville, IL 60048 P: 800-668-ULPA (8572) ● F: 847-362-6443 E: info@ulpa.org ● Web Site: www.ulpa.org APPLICATION I am applying for membership in the ULPA. If elected, I will abide by its bylaws and rules, supports its objectives, and pay its dues. Note: Upon acceptance into membership, your annual dues, pro-rated if applicable, shall be paid within 30 days. Your Name ______________________________ Title _______________________ Company Name _____________________________________________________ Address ____________________________________________________________ City _____________________________________ State _______ Zip___________ Phone ____________________________Fax______________________________ Website ___________________________E-mail___________________________ Division of the Lightning Protection industry with which you are associated: [ ] Dealer [ ] Installer [ ] Manufacturer [ ] Salesman [ ] Other ________________________________ Territory Served ____________________________________________________ Year Company Founded ______________ Year you were hired _______________ Are you listed with U.L. _______________ Member No. _____________________ Type of membership – see attached section of constitution. [ ] Regular [ ] Sustaining [ ] Affiliate Must be nominated by an active member of the same company United Lightning Protection Association, Inc. 426 North Avenue ● Libertyville, IL 60048 P: 800-668-ULPA (8572) ● F: 847-362-6443 E: info@ulpa.org ● Web Site: www.ulpa.org Annual Dues $250.00 $100.00 $250.00 ARTICLE III – MEMBERSHIP Section 1 1.1 Any individual, company, firm, corporation, or other form of enterprise is eligible to be a regular member in the ULPA if engaged in the installation of lightning protection systems that satisfy all applicable United States government regulations and requirements of the Underwriters Laboratories, Inc. (UL96, UL96A) and the Code of the National Fire Protection Association, Inc., No. 78. 1.2 Any individual is eligible to be an affiliate member in the ULPA if he is not otherwise eligible for regular membership, and is an educator, government official, or anyone having a special interest in the lightning protection industry, or is an employee of a regular member. 1.3 Any individual, company, firm, corporation, or other form of enterprise is eligible to be a sustaining member in the ULPA if engaged in the manufacture of lightning protection materials or the furnishing of goods and services to the lightning protection industry. 1.4 Any individual who has made an outstanding contribution to the lightning protection industry is eligible to be an honorary member of the ULPA. Honorary membership shall be by unanimous vote of the board of directors of the ULPA. Honorary members may not hold office and shall pay no dues. ULPA Sponsor / Member you know _________________________________________________ Check of $100.00 for initiation fee is enclosed This fee allows us to process your application, including possibly inspecting recent installations. It is non-refundable. Date ___________________ Signature ___________________________________ [ ] Received ___________________________ [ ] Elected ______________________________ [ ] Acknowledged________________________[ ]New member notified ___________________ [ ]Membership notified___________________