Company Name: *
Address:
Mailing Address (if different):
City:
Province	Ontario British Columbia Quebec Manitoba Saskatchewan Alberta Nova Scotia P.E.I. Newfoundland
Postal Code
Company Contact Name: *
E-mail: *
Phone:
Fax:
Cell:
Member Category *	Builder Renovator Supplier Trade Contractor Service Professional
Company Website:
Products and Services your company provides:
Company Description (as you would like it to appear on our website):
Number of Years in Business
Number of Employees:
GST Number:
WSIB Number:
Payroll Number:
MBA Sponsor Company/Name:
DECLARATION: In submitting this application I state that all information contained on this application to be true and accurate and I authorize the Association to undertake investigative procedures to confirm the accuracy of such information including, but not limited to a verification of the credit worthiness of the applicant and reference checks. I understand that verification of compliance with the membership requirements will be required prior to any membership approval. The Board of Directors reserves the right to reject any application for membership in the Association, or to defer consideration of an application. Should my application be rejected, I agree to fully indemnify and save harmless the Association and its directors from any and all loss, cost, claims or damage of whatever kind and however arising as a result of such refusal of this application.
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