MICHIGAN MONUMENT BUILDERS

1116 E. MT. HOPE AVE.  LANSING, MI  48910   Phone 517-485-2184     Fax 313-531-0757

Application For Consumer Membership

 I wish to apply for membership in the Michigan Monument Builders knowing that in order to qualify, I must abide by the organization's Code of Ethics. 

NAME (PLEASE PRINT)__________________________________________

SIGNED _____________________________________________________

 DATE___________________

 STREET ADDRESS______________________________________________________________

 CITY/STATE____________________________________________ZIP______________________

 TELEPHONE:____________________FAX___________________EMAIL___________________

 Have you previously been a member? ______NO ______YES    1st year of membership__________

 Recommended by__________________________________________________________________

 DO YOU HAVE ANY SPECIAL CONCERNS? __________________________________________________________________________________

__________________________________________________________________________________

 Do you have a website?      YES___     NO____    Web address _______________________________

  DUES ARE PAYABLE IN ADVANCE          First year dues     $25.00        (July 1 – June 30) 

 Please send this application to the address listed above along with your dues.