Membership Application

Our membership will include entrance fee, annual dues and Construction Opportunities Online based on the current fee schedule. View our current Fee Schedule.

A representative will be contacting you shortly to complete your membership with Mid Atlantic BX.

Thank you for your support and welcome to the Mid Atlantic BX!


Company
Company*
Name of Parent Company
Primary Contact*
Title*
Address
Street Address*
City*
State*
Zip*
P.O. Box
P.O. Box City
P.O. Box State
P.O. Box Zip
Other Information
Telephone*
Fax
Email Address*
Web Site URL
No. of Employees*
Type of Business*
Minority Certification (check ALL that apply)*	DBEMBEWBESDVOSBNot Applicable
Labor Affiliation (check ALL that apply)*	UnionNon-UnionNot Applicable
Membership Type	Basic Membership COOL(Construction Opportunities On-Line)*
How did you learn about Mid Atlantic BX?*
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Mid Atlantic BX · 866.499.2665 · MidAtlanticBX.com · 2501 North Front Street · Harrisburg, PA 17110

Pennsylvania	New Jersey	Delaware	Maryland
717-234-3255	856-673-1984	302-533-2510	410-864-8089