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MEMBER APPLICATION

Name of Company: SIC Code:
Type Of Business:
Address: City:
State: Zip:
Telephone: Fax:
Contact Person: Title:
Email:
Full Time Employees In Utah: Referred By:

DUES SCHEDULE
UMA membership dues are based on your number of full-time equivalent employees in Utah

Full Time Employees in Utah / Company Annual Dues
Select Name Price
1-35 Employees  $330.00
36-60 Employees  $385.00
61-100 Employees  $605.00
101-150 Employees  $770.00
151-250 Employees  $1100.00
251-350 Employees  $1540.00
351-500 Employees  $1870.00
500-750 Employees  $2640.00
751-1000 Employees  $3960.00
1001-1500 Employees  $4950.00
1501-2000 Employees  $5940.00
2001-3000 Employees  $6600.00
3001-5000 Employees  $9020.00
Over 5000 Employees  $11800.00
Other Contacts:
President/Owner: Email:
V.P. / CFO / COO: Email:
HR Director: Email:
General / Plant Mgr: Email:
Transportation Director: Email:
Legislative Director: Email:
Sales Director: Email:
Safety Manager: Email:

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