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PENNSYLVANIA INDEPENDENT WASTE HAULERS
ASSOCIATION
PO BOX 2609
∙ IVYLAND, PA 18974 ∙ 215-675-8000
PAINDEPENDENTWASTEHAULERS@YAHOO.COM
WWW.PIWHA.COM
2012 MEMBERSHIP APPLICATION
COMPANY
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PHYSICAL ADDRESS
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MAILING ADDRESS
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CITY, ST
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PHONE #
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FAX #
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CONTACT (1)
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E-MAIL
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CONTACT (2)
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E-MAIL
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WEB SITE
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# OF TRUCKS
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COUNTIES YOU PROVIDE SERVICES IN?
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WHAT
TYPE OF SERVICE DOES YOUR COMPANY OFFER?
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DUES
1 TO 3 TRUCKS
$ 500.00
4 TO 9 TRUCKS
$ 700.00
9 OR MORE
$ 1,000.00
ASSOCIATE MEMBERS $ 300.00
DUES MUST BE PAID IN FULL
BY FEBRUARY 15TH 2012 . PLEASE MAKE ALL CHECKS PAYABLE TO:
PIWHA
ATTN: JASON LECK
PO BOX 2609
IVYLAND PA, 18974-2609
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