Golden State Chimney Sweep Guild
www.cachimneysweepsguild.org
Membership Application
Golden State Chimney Sweep
Guild Membership is $150.00 per fiscal year, 11/1 thru 10/31.
All memberships expire 10/31. All members will receive the following:
*
GSCSG quarterly publication: ChimNews
*
Registration reduction to the Convention & Trade Shows
* FREE WORKSHOP (Northern or Southern)
* Membership Certificate (suitable for framing)
* Membership Embroidery patch (new member)
* Official GSCSG T-Shirt (new member)
* GSCSG logo advertising slicks (requested)
* 2 GSCSG vehicle decals (requested)
* ID badge 1-1/2x1-1/2 photo (optional)
New or Renewal
(Circle one)
PLEASE PRINT CLEARLY
Date _________________
Name
Spouse |
Business Name |
Address
City, State, Zip |
Business Phone ( )
Fax # ( ) |
Home Phone
( )
Email: |
Website: |
Additional Members $100.00 each
T-Shirt size (new member only) |
Spouse |
Employee
Employee |
Additional Information can be written on the back: Send employee packet to:__________________________
GSCSG Certified: Yes No
Certification # ________________ Expires ____________
C.S.I.A. Certified:
Yes
No
Certification # ________________ Expires ____________
F.I.R.E. Certified: Yes
No
Certification # ________________ Expires ____________
N.F.I. Certified:
Yes No
Certification # ________________ Expires ____________
State Licensed Contractor?
Yes No
License Classification(s) ___________________________
Interested in
being a mentor? Yes No
Please send completed
application, your check, and/or credit card information along with 2 business cards to:
G.S.C.S.G. Treasurer
Tom Gallagher
46200 30th Street East
Lancaster, CA 93535
Ph
# 661-946-2375
Visa or Master Card: # __________________________________________________
Expires _____________
Signature _________________________________________________________________________________
For more information, call or email:
Membership
Director: Charlie Baltimore
661-816-1178
or charliethechimneysweep@yahoo.com
Rev. 5/27/08
