GBRIA Membership Interest Form

Name

Company

Address

Address 2

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

Magazine or Newpaper

Word of Mouth

Other (please specify)

Yes

Other (please specify)

Average employee headcount as full-time equivalents (FTE's) for past 2 years.

Average CONTRACTOR headcount as full-time equivalents (FTE's) for past 2 years.

Please list planned construction start date

Please list how many FTE company employees, on average, will be working in the local region on your site during construction

Please list how many FTE CONTRACT employees, at peak construction, will be working in the local region on your site during construction

Please list planned plant start-up date