Minnesota Association of Asphalt Paving Technologists

Application for Membership

You can apply by either filling out the form below and mailing $25 to the address listed, or you can print this form (.pdf) 2012 Membership Application, fill it out, and mail it with your $25. If you are attending one of the Lunch & Learn events on 1/31/12 or 2/7/12, the cost to join is ONLY $15.

I hereby apply for membership in the Minnesota Association of Asphalt Paving Technologists and submit the following statement of my qualifications: (all fields required)

First Name:
Last Name:
Home Address:
City:
State:
Zip Code:
Business Affiliation:
Business Address:
City:
State:
Zip Code:
Business Phone:
Email:
Present Title:
Birth Date:
Education/Experience:

Dues:	$15.00 Annually
Initiation Fee:	$10.00 (new members only, one-time fee)
Please Remit:	$25.00 upon submission of this application to: P.O. Box 120461 New Brighton, MN 55112

I hereby declare that, if elected to membership, I will abide by the Constitution and By-Laws of the organization and cooperate in its activities: (entering your full name below will serve as your signature)

Signed:

Questions? Comments? Please feel free to contact us by email at info@mn-aapt.org or call (651) 631-0156.