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MicroNet Template
Memberzone
2017-01-16T16:42:19+00:00
Member Application
Thank you for your interest in our organization. We would love to have you be an active participant in the work that we do for our industry and our community.
Step 1:
Member Info
Step 2:
Additional Info
Step 3:
Primary Contact
Step 4:
Billing Contact
Step 5:
Membership Options
Step 1:
Member Info
Company Name
*
Please add your company name.
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Phone
*
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Website
Email
*
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Physical Address
Address line 1
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Address line 2
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Afghanistan
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Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
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Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
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Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
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Macedonia, FYRO
Malaysia
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Malta
Mexico
Moldova
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Mongolia
Montenegro
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Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
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Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
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Maryland
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State
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Alberta
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Northwest Territories
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Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Please add your State.
State
*
Please add your State.
Postal Code
*
Please add your Postal Code.
Mailing Address
Same as physical address
Address line 1
*
Please add your address.
Address line 2
Country
*
Choose...
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
Please add your country.
City
*
Please add your City.
State
*
Choose...
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please add your State.
State
*
Choose...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Please add your State.
State
*
Please add your State.
Postal Code
*
Please add your Postal Code.
Social Network Addresses
LinkedIn
Facebook
Step 2:
Additional Info
Business Description (200 char max)
Business Keywords
(enter a space between words)
Directory Category
*
Choose...
Accounting
Advertising/Publications
Apparel
Appliances
Appraisals
Architects
Automotive Services
Bottled & Soft Water Supply
Brick Supplier
Bricking/Masonry
Builder
Building Design Services
Building Materials
Business & Legal Services
Cabinet/Carpentry
Cable Contractor
Carpet & Cleaning Services
Catering
CATV Phone & Network Cabling
City
Commercial Contracting
Communications
Computer Services
Concrete
Construction Clean Up
Counter Tops
Developer
Dirt Work/Ditching
Drywall
EFIS/Stucco
Electrical Services
Entertainment
Environmental Services
Equipment Rentals
Excavating
Fencing Services
Financial
Fire Sprinklers
Fireplaces
Flooring & Tile
Floral
Food & Beverage
Framing
Garage/Overhead Doors
Glass/Mirrors
Green Building
Gutters
Hair Salon
Hardware
Home Theatre Sales & Installation
Home Warranty
Hotels
Inspections
Insulation
Insurance
Interior Design
Iron Works
Landscape & Irrigation
Lighting Services
Medical Services
Miscellaneous Services
Non-Profit Organizations
Office Supplies/Technologies
Ornamental Iron
Painting/Special Finishes
Patio Supplies
Paving
Payroll Services
Pest Control Services
Photography
Plumbing & HVAC
Pools & Services
Printing Services
Promotional Products
Realtors/Real Estate
Retail
Roofing
Sanitation & Septic Systems
Security/Electronic Services
Signs
State
Steel
Storage Rentals
Subcontractor/Remodeler
Surveying/Engineering
Title Company
Travel Services
Utilities
Water Treatment
Window Treatments/Shutters
Please select a directory category.
Who can we give credit for recruiting you?
*
Looks good!
Step 3:
Primary Contact
First Name
*
Please add your first name.
Last Name
*
Please add your last name.
Title
Phone
*
Please add your phone number.
Cell Phone
*
Please add your cell phone number.
Email
*
Please add a valid email.
Contact Preference
Email
Phone
Address
Same as Address in Step 1
Address line 1
*
Please add your address.
Address line 2
Country
*
Choose...
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
Please add your country.
City
*
Please add your City.
State
*
Choose...
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Please add your State.
State
*
Choose...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Please add your State.
State
*
Please add your State.
Postal Code
*
Please add your Postal Code.
Social Network Addresses
LinkedIn
Facebook
Create Account
This Login is already in use
Login
*
Please add your login username.
Password
*
Please add your login password.
Step 4:
Billing Contact
Same as Primary Contact
First Name
Last Name
Title
Phone
Cell Phone
Email
Contact Preference
Email
Phone
Address
Same as Primary Contact Address
Address line 1
Address line 2
Country
Choose...
Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
British Virgin Islands
Brunei
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo (DRC)
Costa Rica
Côte d’Ivoire
Croatia
Cuba
Czechia
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Ghana
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Laos
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia, FYRO
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Monaco
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Venezuela
Vietnam
World
Yemen
City
State
Choose...
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
*
Choose...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Please add your State.
State
Postal Code
Social Network Addresses
LinkedIn
Facebook
Create Account
This Login is already in use
Login
Password
Step 5:
Membership Package
Please select a Membership Package
Builder Member
$
600
Open to any person whose business is the construction of housing, or land development, in Lubbock or surrounding counties within our jurisdiction.
Associate Member
$
600
Open to any person, firm or corporation engaged in any allied industry or profession in Lubbock or surrounding counties within our jurisdiction.
Comments/Questions
Payment Option
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