Central
New York Chapter
Central
New York Chapter
American Society of Home Inspectors
Application For Chapter Membership
Annual dues are $100.00. After July 1st the dues are $50.00.
Please print and fill out this form and bring it to the next meeting or mail to the Chapter secretary at:
Mike Chapman, Closer Look Home Inspection, 4259 Virgo Course, Liverpool, NY 13090
(Remember to include a check made out to Central New York ASHI in the amount of $100. After July 1st the initial dues are $50.00)
| NAME: | ____________________________________________________________________________ |
| HOME ADDRESS | ____________________________________________________________________________ |
| BUSINESS NAME | ____________________________________________________________________________ |
| BUSINESS ADDRESS | ____________________________________________________________________________ |
| HOME PHONE | ____________________________________________________________________________ |
| BUSINESS PHONE | ____________________________________________________________________________ |
| FAX | ____________________________________________________________________________ |
| ____________________________________________________________________________ | |
| ASHI NATIONAL STATUS | (CIRCLE ONE) MEMBER C1-CANDIDATE C-2 CANDIDATE NONE |
| AREAS OF EXPERTISE | ____________________________________________________________________________ |
| HOW DID YOU HEAR ABOUT CHAPTER? | ____________________________________________________________________________ |
| SIGNATURE AND DATE | ____________________________________________________________________________ |
| ADDITIONAL COMMENTS | |
