SCHOA VENDOR REFERRAL PROGRAM   Paid $                               Ck/Cash                     
                $35.00 YEARLY DUES – ONE CATEGORY; $5.00 EACH ADDITIONAL CATEGORY
LIST DATE                            VENDOR NUMBER         TRADE CATEGORY           LICENSE #
                                                                                                                                                                     

Date dropped                                                                                                                                              

Reason                                                                                                                                                        

               (failed to renew; voluntary; complaints, etc.)                                                                              
VENDOR:  Please include license number(s) above, then complete bottom portion of page.  SCHOA will
 complete the remainder of the upper portion of the form.  Thank you.

                     
Company Name
                                                                                                                                                  
Address                                                                                                                                                                
City                                                                            State                                                  Zip                        
Telephone                                                                 Cell Phone or 2nd Phone                                                 
Owner or Contact
                                                                                                                                            
E-mail                                                                                                                                                                  
Brief Statement of Services you provide                                                                                                          
                                                                                                                                                                             
REFERENCES: Please list three local references you have provided services within the last three
(3) months.  Your listing as a vendor will not become effective until these references have been checked.

                      

Name                                                                          City                                         Phone                         

SCHOA comments:                                                                                                                                          

Name                                                                          City                                         Phone                         

SCHOA comments:                                                                                                                                          

Name                                                                          City                                         Phone                         

SCHOA comments:                                                                                                                                          

GOLD SPONSOR:  This signature acknowledges that the above vendor wishes to become a Gold Plus
vendor with a commitment to offer a minimum 5% discount on labor to members of SCHOA.  No
additional fee is required to be a Gold Plus sponsor.

 

Business Name                                                                                                  Date                                      

     

By                                                                                                                                                                      

 

SCHOA POLICY ON UNDOCUMENTED WORKERS

I, ________________________________, agree that                                                                                       

                                                                                                (Name of Company)    

in order to be listed and remain on the SCHOA Vendor Referral Program, will not knowingly hire, employ,
or continue to employ any undocumented workers.  An undocumented worker is a foreign national who
resides in the U.S. unlawfully, either by entering the U.S. at a place other than a designated port-of-entry or
as a result of the expiration of a non-immigrant visa.
      

By:                                                                                               Date: