PCUCA: JOIN PCUCA

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Please provide us with your company information:

Company *

Contact *

Organization *

Street Address *

City *

State *

Zip Code *

Work Phone *

Home Phone

Fax

E-mail Address

URL

Number of Years in Business:

Number of employess:

Gross Annual Sales

Services Offered (please list)

Cleaning Methods Used: Please check all methods that apply

Dry Foam

Shampoo

Bonnett

Steam Extraction

Dry Extraction

Certifications Held: Please check all methods that apply

CCMT- Commercial Carpet Maintenance Technician

HST- Health & Safety Technician

UFT- Certified Upholstery & Fabric Cleaning Technician

WRT- Certified Water Damage Technician

RRT- Certified Repair & Reinstallation Technician

CRT- Certified Color Repair Technician

FCT- Hard Surface Floor Care Technician

FSRT- Certified Fire & Smoke Restoration Technician

OCT- Certified Odor Control Technician

ASD- Applied Structural Drying Technician

AMRT- Applied Microbial Remediation Technician

AMRS- Applied Microbial Remediation Specialist

SCI- Senior Credentialed Carpet Inspector

SSI- Substrate Subfloor Inspector

MSI- Marble & Stone Inspector

RSI- Resilient Flooring Inspector

CTI- Ceramic Tile Inspector

WLFI- Wood Laminate Flooring Inspector

JTC- Journeyman Textile Cleaner

JSR- Journeyman Fire & Smoke Restorer

JWR- Journeyman Water Restorer

MTC- Master Textile Cleaner

MSR- Master Fire & Smoke Restorer

MWR- Master Water Restorer

Is your company IICRC certified?

Name your business liability agent:

Sponsoring Member:

Additional Feedback or Comments

Yes! Please sign me up as a: REGULAR MEMBER (cleaning, restoration company)

Application Fee (required) $35.00

Denver Region (within 75 miles) $225.00

Colorado Region & Out of State (outside 75 mile radius of Denver) $150.00

IICRC Fee (Select if you are not a certified firm) $95.00

ASSOCIATE MEMBER: (supplier, manufacturer, distributor) $225.00

Total Dues and Fees to be processed: *

Total Dues and Fees to be processed (again, to confirm) *

Method of Payment *

Credit Card Number (no spaces)

Expiration Date

If paying by check, please submit the completed on-line form at this time and drop your check in the mail. Please make checks payable to PCUCA. 3290 Pierce St Wheatridge, CO 80033 Application will be reviewed and submitted for approval upon receipt of check.

MEMBERSHIP AGREEMENT: Member agrees to abide by the by-laws of the Professional Carpet & Upholstery Cleaners Association. Member also agrees: That it shall use the PCUCA logo and name in all forms only when a fully paid member in good standing; and That it shall conform to the advertising standards established by the PCUCA. By submitting the on-line order form, you further agree to pay all legal costs in the event legal action is necessary to enforce the above agreement. APPLICATION WILL BE REVIEWED and submitted for approval by the PCUCA Board of Directors and membership. Membership is probationary for 30 days after approval. If not accepted for membership, the applicant dues WILL BE refunded.

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