Minnesota LICA
Associates Application
Please print out this page, fill in the information and send to:
MnLICA, 9600 South Dennison Blvd., Northfield, MN 55057-4547
-Questions??? Please call: Phone: 507-789-5725
Or Cell# 507-649-1771 for more information.
*Fax 507-789-6033
Please enroll me as an Associate Member of the Minnesota Land Improvement Contractors of America. I understand that I will receive MnLICA newsletter, a directory and for a fee I can attend any workshop, convention or class getting the same credits from the University of Minnesota as the members.
COMPANY: ___________________________________________________
CONTACT PERSON: ___________________________________________
ADDRESS: ___________________________________________________
CITY: _____________________ STATE: ______________ ZIP: _________
TEL #: ________________________ FAX #: _________________________
E-MAIL: ______________________________________________________
WEB SITE: ____________________________________________________
PRINCIPAL PRODUCT: __________________________________________
______________________________________________________________
Annual Dues is $200.00
Remit to:
MnLICA – c/o Jeanie Bakken
9600 S. Dennison Blvd.
Northfield, MN 55057-4547