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 $1100 ($600 State / $500 National) Annual Volume Between $2 and $5 million $2695 ($1470 State / $1225 National) $5 million to $10 million $3245 ($1770 State/$1475 National) Over $10 million $3795 ($2070 State / $1725 National)
Associate	Annual Volume Below $2 million $1265 ($690 State / $575 National) Annual Volume between $2 and $10 million $1705 ($930 State / $775 National) Over $10 million $2145 ($1170 State / $975 National)
Institutional	$880 ($480 State / $400 National)
MultiLocation	$275 National (plus applicable state dues for your category)