American Concrete Pumping Association

The Source for Concrete Pumpers, Concrete Pumping, Contractors, Manufacturers, Safety Programs, Concrete Equipment Insurance and more.

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Join the ACPA - Open publication - Free publishing - More pumping Benefits of Membership Safety materials at discounted rates (videos, manuals, training programs, posters, seminars) Operator Certification at discounted rates Company listing on the ACPA website Member Map Subscription to Concrete Pumping magazine Newsletters, emails, and special mailings of safety materials Legislative representation and advocacy This form is for companies in the Concrete Industy, interested in gaining membership in the ACPA. Please fill out every question.
Company Information	* required information
* Company Name
* Contact Name and Title (for Voting)
* Address
* City
* State/Province	Province:
* Zip/Postal Code
* Country (One Time Registration Fee of $250 for International Members)
* Telephone
Toll-Free
Fax
* Email Address
Website	(ie. www.yoursite.com, NOT http://www.yoursite.com)
Number of Other Office Locations
$100.00 additional dues per year for each branch or office you want listed for mailings. We will require the address listing for all branches you submit, when we contact you.

Please choose the category that most accurately describes your company.
Category 1: Trailer Pumps Pricing 0-5 units: $320 6+ units: $320 +$20 per pump	How many Trailer Pumps do you operate?
Category 3: Boom Pumps Pricing - 1 Pump $355 - More than 1 Pump $355 + $35 per boom pump - Line Pumps + $20 per line	How many: Boom Pumps do you operate? Line Pumps do you operate?
Category 4: Distributor of Concrete Pumps/Equipment - $705
Category 5: Manufacturer of Concrete Pumps and equipment Boom Manufacturer-$4,240 Small Line Pump Manufacturer-$2,120 Systems and Parts Manufacturer-$1,700
Category 6: Affiliate Membership - Professional - $530 (Non-Voting) Membership limited to persons, firms or legally established business entities engaged in the business of furnishing to members supplies, services or products aligned with the concrete pumping industry. (non-owners of concrete pumps) Accounting and Legal Services Appraisals Boom Inspections Finance Companies Insurance Other If other, please specify:
Category 7: Individual Membership - $135 (Non-Voting) Current or retired operators, students or individuals subject to the discretion of the ACPA National Office and/or Membership Committee
Verification Code:	Please enter the code you see to the left.
$100.00 additional dues per year for each branch or office you want listed for mailings. We will require the address listing for all branches you submit, when we contact you.

American Concrete Pumping Association • 606 Enterprise Dr. • Lewis Center, OH 43035 • (614) 431-5618

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