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Company Name
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Business Phone Number
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First name of Primary Contact
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Last name of Primary Contact
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Member ID
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Please list names and emails of other employees who may be partaking in membership activities
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Is this your first time joining NARI
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Yes
NO
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NARI Certifications
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CR - Certified Remodeler
CRS - Certified Remodeler Specialist
CRA - Certified Remodeler Associate
CLC - Certified Lead Carpenter
CKBR - Certified Kitchen & Bath Remodeler
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EPA Certified Firm Number
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Other Certifications
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Business Type
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Remodeler/Contractor
Sub/Specialty Contractor
Supplier
Vendor of Support Services
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Email address
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Cellphone Number
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Address 1
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City
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State
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ZIP
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Website
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Twitter Handle
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Remodeling Specialties
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Accounting Services
Additions
Air Conditioning
Appliance Sales
Architect
Basement Remodeling
Bath - Remodeling
Business Services
Cabinet Installer
Cabinet Maker
Cabinet Refacing
Chimney
Closet/Storage Systems
Computer Services
Countertops
Deck Contractor
Decorating
Design - Project Planning
Doors - Passage, Overhead
Electrical
Excavating
Fencing
Financing
Fireplaces
Flooring
Foundations & Repair
Garage
Glass
Gutters
Handyman Services
Hardware
Heating
Home Restoration
Insulation
Insurance
Interior Design
Kitchen Design
Kitchen Remodeling
Landscape
Legal
Libraries - Residential
Lighting
Lumber/Millwork
Marketing
New Item
Paint
Photography
Plaster/Drywall
Plumbing
Pools - Spas, Hot Tubs
Remodeler-General-Carpenter
Remodeling Contractors
Renovation - Guidance, Planning, Management
Rental - Equipment
Roofing
Security
Siding
Solar
Stairways
Stone
Sunrooms, Screen Enclosures, Greenhouses
Supplier-General
Theater
Tile
Vacuum Systems
Video Services
Wallpaper
Website Design
Window Treatments - Blides, Shades, Shutters
Windows & Doors
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PA Registration Number (If you are NOT a Contractor please list your insurance policy holder
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Blog
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Group Participation
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Designers
Remodelers
Vendors
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How did you find out about Bucks-Mont NARI
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Saw you in House and Home Magazine
Saw an event sign / promotion
Referred by national headquarters
Received an unsolicited email
Internet Search
Other_______
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Other (List Name or Other Sources Of Referral)
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Directory listing text
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Which Committees Would You Be Interested In Joining
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Community Service
CotY awards
Education
Finance
Membership
Programming
Vendor Advisory Committee
None/ Will Decide Later
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Please indicate your approximate percentage of volume in each of the following areas: 0-100%,
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What Areas Do You Specialize In:
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Roofing
Replacement Windows
Insulation
General Remodeling
Kitchen/bath
Electrical
Siding
Heating/AC
Other______
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List Other
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Annual Sales Volume
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Under $500,000
$500,000 to $1,000,000
$1,000,000 - $5,000,000
Over $5,000,000
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Date Company Was Established
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Number of Full-Time Employees
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Company Type
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Closely-held Corporation
Partnership
Public Corporation
Sole Proprietorship
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Name of Customer Reference
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Customer Reference Phone Number
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Customer Reference Address/City/State/Zip
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Trade Reference Name
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Trade Reference Phone Number
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Trade Reference Address/ City/ State/ Zip
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Terms and Policies
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Yes
No
or
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