AMTOP Membership Application Form

(This information will be included in the Membership Directory)

 

Company Name: ______________________________________________

 

Contact Person: _________________________Title: _________________

 

Address: _____________________________________________________

 

City: __________________________ State: ____________ Zip: _________

 

Phone & Fax:____________________________ E-mail: _______________

 

Segment of Industry:

_____ Sod         _____ Fertilizer Chemicals_____ Large Equipment           _____ Lawn Care

_____ Tree Care_____ Sports Turf             _____ Spray Equipment           _____ Lighting

_____ Irrigation  _____ Nursery                 _____ Stone/Hardscape           _____ Trucks & trailers

_____ Mowers & Power Equipment           _____ Business Services          _____ Decorative items

_____ Garden Center                               _____ Hydro seeding                _____ Pest Control       

_____ Pesticide Applicator                       ____ Other

 

Regular Membership:                                                       $95.00

Any person, firm, partnership or

Corporation, including employees.

 

Associate Membership:                                                   $50.00

Any person, firm, partnership or

Corporation, including employees,

not involved in the actual application of pesticides.

 

Corporate Membership:                                                   $800.00

Any firm, partnership or corporation in the

business of providing services and/or materials

 to AMTOP members.

 

Total Enclosed for Membership:                                                                $_______

 

Make checks payable to AMTOP, P.O. Box 4518, Helena, MT 59604