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Political Advocacy Membership Application
To join and remain a PAMC member, you only need to complete this form once. If your information changes or you have questions about PAMC membership, visit
AsphaltPavement.org
for details and contacts.
*
1.
Your Information
(Required.)
First Name
Last Name
Email
Primary Phone
Job Title
2.
Cell Phone (optional)
*
3.
Your Employer
(Required.)
Member Company Name
*
Address
*
Address 2
City
*
State/Province (use postal abbreviation)
*
ZIP/Postal Code
*
Country
*
By submitting this form, you affirm that you are eligible for membership in this category as a full-time employee of a NAPA Producer or Associate member and you agree to receive information from NAPA as a participant in its Political Advocacy Member Council.
Questions about this membership or application? Visit
AsphaltPavement.org
for more information and whom to contact.
