CA Chimney Sweep Guild
CA Chimney Sweep Guild
CA Chimney Sweep Guild
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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