LSASHI

Lone Star ASHI Membership application

Please fill out the following information.

Thank you for joining Lone Star ASHI.

Paul Roebuck President

Please return ASAP to:

Jim Hemsell 3112 Ottawa Denton, TX 76210

Lone Star ASHI Chapter Application Form
Name
Company Name
Address
City
State
Zip Code
Work Phone Number
Fax Number
Email Address
Web site Address
ASHI Membership #
TREC License type
TREC Inspector #

The following information is requested for private communication needs and the information will not be published.
Home phone number:

I wish to join Lone Star ASHI. I have read the chapter bylaws and agree to abide by them.

This membership will be through June 31^st 2008. Dues for next year will be due July 1^st 2008. Dues for this year are $150.00

You must complete the application to ASHI National before July 1^st 2008.

Signed ________________________