Author: Katie

2024 WPCA MEMBERSHIP APPLICATION

Membership Type: □ Renewal □ New Member

STOP! For faster service and to pay by credit card, please renew & pay on-line at www.wiprecast.org

□ Manufacturer Member* □ Associate Member Select one:
___Manufacture 1-100 Tanks/Yr. $500 Non-manufacturer $400 ___Manufacture 101-500 Tanks/Yr. $875 but wishing to support ___Manufacture 501-1,000 Tanks/Yr. $1,430 the precast industry ___Manufacture 1,001-2,000 Tanks/Yr. $1,800 ___Manufacture 2,001-3,000 Tanks/Yr. $2,175 ___Manufacture 3,001+ Tanks/Yr. $2,545
*One membership per concrete product manufacturing company. The dues amount is based on total number of tanks produced at all of your company’s plants in previous year.

Member Contact Information: Please print clearly.
Name _________________________________________ Company Name _______________________________________________
Address ________________________________________City/State/Zip_________________________________________________
Title __________________________________________ Phone ___________________________ Fax _________________________
Email _______________________________ Website _________________________ County ________________________________

Additional Individuals to receive WPCA Communications: Please print clearly.
Name ____________________________________________ Email ___________________________________________________
Name ____________________________________________ Email ___________________________________________________
Name ____________________________________________ Email ___________________________________________________
Name ____________________________________________ Email ___________________________________________________

Please list all PRODUCTS manufactured by your company:
______________________________________________________
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______________________________________________________
______________________________________________________
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□ Donate to the WPCA Scholarship Fund: _______________________________________________

Payment Amount (Membership + Scholarship Donation if applicable): $ __________ □ Check enclosed (Payable to WPCA)

Please return to WPCA:
10 E. Doty Street, Suite 523, Madison, WI 53703
Phone: 608-441-1436 Email: wpca@kpasllc.om Fax: 608-441-1435

PLEASE NOTE: Approximately 25% of your annual WPCA dues are spent on lobbying related issues. This 25% may not be deducted from your taxes as a business expense. Please contact your tax consultant for further information.