Application for Association Membership
Eastern Panhandle Home Builders Association
430 Randolph St., Suite C    Martinsburg WV  25401
PH: 304-267-4710   FAX: 304-267-8901
Email: Info@EasternWVHomeBuilders.org

Date: ___________________                                       Contractor License #: ___________________
Company Name: ___________________________________ 
Applicant’s Name: __________________________________  Title: _________________________
Telephone No.: _____________________ Fax No.: _____________________
Cell: _____________________  E-Mail: ________________________________________________
Do you want your cell no. and email address Published (P) or Not Published (N) in EPHBA directory, website, etc.?  Please circle preference - Cell:  P   N     Email:  P   N   
Website: _____________________________________
Business Address:___________________________________________________________________
City: ______________________________________ State: ________________ Zip: ______________

Membership Classification:
Please check one:         Please complete this section for Builder and Associate  Members only (Refer to following page for reporting code information.)  

Other Business Classifications (Please Specify):_______________________________________

______ I am interested in serving on a committee, please contact me.

Business References:________________________________________________________________

___________________________________________________________________________________________________________________

I agree to abide by the constitution and bylaws of the Eastern Panhandle Home Builders Association (EPHBA) to which this membership application is being directed, as well as, of the National Association of Home Builders of the United States and the Home Builders Association of West Virginia, with which it is affiliated.

Business/Personal Fax, Telephone & Email:  I understand that by providing the fax number listed above and signing this application on behalf of my company/organization, I consent to receive faxes, emails, and telephone calls from the Eastern Panhandle Home Builders Association, the HBAWV,  and the NAHB. 

A remittance of $______________ representing my annual membership dues accompanies this application.

Signature of Applicant ______________________________________________________     

Name of Sponsor______________________________________________________________

IMPORTANT NOTICE
Although dues Payments to EPHBA are not deductible as charitable contributions for federal income tax purposes, they may be deductible as an ordinary and necessary business expense, subject to an exclusion for lobbying activity. Because a portion of your dues is used for lobbying by the NAHB and the HBAWV, $ 24.66, for Builder and Associate Members, and $3.90 for Affiliate’s Dues, is not deductible for income tax purposes.

NAHB Membership Information Reporting Codes
 Business Activity Codes: Enter the member’s most important business activities from the list of codes below (enter up to 2 different codes). Note: For "other" associate (code Z), please specify in the blank on the application for "Other Business Classifications".
Total Paid Employees:  Please include total number of paid employees including the applying representative.