Membership Application

Sign up to become a member today!

Please mail your check to:
NUCA of Indiana
10455 N. College Ave.

Indianapolis, IN 46280

Phone: 317-574-0862
Fax: 317-574-0969

Name
Title
Company
Address
City
State
Zip
Telephone	xxx-xxx-xxxx
Fax	xxx-xxx-xxxx
E-mail
How did you hear about NUCA of Indiana?
Membership Type
Contractor	Annual Volume Below $2 million $1250 ($625 State / $525 National) Annual Volume Between $2 and $5 million $2520 ($1260 State / $1260 National) $5 million to $10 million $3040 ($1520 State / $1520 National) Over $10 million $3550 ($1775 State / $1775 National)
Associate	Annual Volume Below $2 million $1190 ($590 State / $590 National) Annual Volume between $2 and $10 million $1590 ($795 State / $795 National) Over $10 million $2000 ($1000 State / $1000 National)
Institutional	$400 ($400 State)
MultiLocation	$275 National (plus applicable state dues for your category)