Major Corporate Group Membership Application MEMBERSHIP TYPE Title Major Corporate Owner $10,000 Annually Corporations and organizations whose primary trade is not directly construction-related, but who have dedicated capital budgets for building and infrastructure projects as well as the ability to offer contracting opportunities to NAMC members. Major Corporate Partner $5,000 AnnuallCorporations and organizations engaged in the construction or development market and/or are capable of awarding subcontracting work. Gov’t Entity Or Nonprofit $2,500 AnnuallyGovernment and public organizations that have dedicated capital budgets for building, maintenance, and repair projects, as well as the ability to offer contracting opportunities to NAMC members. GENERAL INFORMATIONCompany Name Primary Phone NumberSecondary Phone NumberFaxCompany Website CONTRACTOR PRE-QUALIFICATION WEBSITE (If applicable) Would You Like Your Company Logo, Which Will Appear On Namc’s Website, Linked To Your Company Website? Yes No ADDRESSESPrimary Physical Address Street Address City State / Province / Region ZIP / Postal Code Billing Address (If different than above) Street Address City State / Province / Region ZIP / Postal Code COMPANY REPRESENTATIVE CONTACT INFORMATION Primary Contact Or Diversity Representative Contact Name PhoneCellFaxEmail Project Manager Or Procurement Officer Contact Name PhoneCellFaxEmail ADDITIONAL OFFICE LOCATIONS (Optional - Use additional sheet if desired) Office 1 Street Address City State / Province / Region ZIP / Postal Code Office 2 Street Address City State / Province / Region ZIP / Postal Code COMPANY DEMOGRAPHICSYear Company Established Number Of Employees Annual Contracting Volume < $1 MILLION $1 - $5 MILLION $6 - $10 MILLION $11 - $20 MILLION $21 - $30 MILLION > $30 MILLION AUTHORIZED SIGNATURE I hereby make application for membership in the National Association of Minority Contractors (NAMC) and agree to its mission, vision, purpose, and values. I certify that all information provided is correct to the best of my knowledge. I also understand that by providing contact information, I consent to receive communications sent by or on behalf of NAMC and/or its affiliates via mail, email, phone, or fax.Printed Name Date MM slash DD slash YYYY SignatureCommentsThis field is for validation purposes and should be left unchanged.