MIC Membership Application

MEMBERSHIP DUES (per year)

1-10 employees                 $300

11-20 employees               $600

21-50 employees               $900

51-99 employees               $1,500

100+ employees                 Please call

General MIC\TMA Membership Benefits Include

Collective representation for community and individual business concerns. 

The MIC and TMA will lend their group support to deal with government agencies on behalf of your individual business, business group or business neighborhood.

Effective: 2013

Company Name (required)

Contact Name (required)

Title

Street Address

City
State
ZIP

MAILING ADDRESS

Street

City State ZIP

Telephone

Cell Phone Email:

Please select categories that describe your business:

Business Type
ManufacturingConstructionWarehouseWholesaleMarineTransportationServiceRetail

Year Company started

Number of employees
FT PT

CHECK ANNUAL MEMBERSHIP DUES
1-10 employees $30011-20 employees $60021-50 employees $90051-99 employees $1,500100+ employees (please call)

MIC Area of Interest
Core Plus/EducationEnvironmental CleanupFreight MobilityPolitical EngagementCommunity Engagement/Networking

Digital Signature Date