MEMBERSHIP IS REWARDING

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1 MEMBERSHIP IS REWARDING 3:1 Association Membership Networking at its BEST Doing Business with Members LOCAL Local Promotion & Referrals Advertising Opportunities Membership Meetings Educational Seminars Tools & Resources to do business BETTER Discounted rates in the Sport & Home Extravaganza (Home Expo Event) Parade of Homes Meeting Room Use 5% Fuel Savings Kwik Trip National Purchasing Partners (NPP) Verizon Wireless Discounts (some regulations apply) Scholarships Professional Stamp of Approval STATE Advocacy to save you $$! Free Legal Hotline Free Building Code Hotline Rebate Program: 70% of the builders and remodelers get back more in rebates than they pay in annual dues Insurance Discounts Access to Contracts made to protect YOU Statewide Networking Events NATIONAL Various Discounts and Promotions Including: 2% Lowe s, $500 General Motors Private Offer Rebate, AT&T, Verizon, Sprint & T-Mobile up to 35% savings, 2-10 Home Buyer Warranty, UPS Savings Program & YRC Freight, TransFirst Payment Solutions, Dell, Associated Petroleum Products, GEICO, Hertz, Avis, Budget, Hewlett Packard, Office Depot, Omaha Steaks, Endless Vacation Rentals, Wyndham Hotel Group and FTD JOIN TODAY! Call or to request an application or schedule an appointment to learn more about the benefits of membership. Home BuildersFdlDodge.com

2 Date Application for Membership Last Name First Name Middle Title Federal ID # Company Name Business Address City ZIP Telephone ( ) Mobile ( ) Fax ( ) Website Date Business Registered with the State of Wisconsin Number of Years in Business Type of Business Bank Reference(s) Membership Classification: Builder 1. Dwelling Contractor Qualifier (State of Wisconsin Educational Requirements) # 2. Dwelling Contractor (Financial Responsibility Certification) # Associate 1. Contractor Registration (4 yr) # NAHB MEMBER ID CODE (see attached sheet) Business Activities $Vol Units #of Employees Title PAST Customers (please list three) 1 Phone No Contact 2 Phone No Contact 3 Phone No Contact Supplier References (please list three) 1 Phone No Contact 2 Phone No Contact 3 Phone No Contact Have you ever done business under another name? Yes No If yes, list: 1

3 Has applicant, owner or majority shareholder been declared bankrupt within the past seven years? Yes No If so when, and under what name?: Are there any industry-related judgments, claims, settlements, or lawsuits involving you or any company with which you have ownership? Yes No. If yes, please explain Have you ever been arrested for, charged with, convicted of, or entered a plea of guilty or no contest to a civil law violation, local ordinance violation or a criminal charge? (Omit traffic tickets, parking violations, and all moving violations.) You must disclose each instance, whether the arrest, judgment, conviction, or sentence has been withheld or expunged, or the record sealed. Yes No If yes, please explain Are you presently delinquent or in default on any industry-related loan, mortgage financial obligation or loan guarantee? Yes No If yes, please explain Have you or any businesses you own or control, ever applied for and been denied membership in any Home Builders Association in this state or any other state? Yes No If yes, please fully explain and provide the name and address of each Home Builders Association for which your membership was denied. Have you, or any business you own or control, ever had your membership in any Home Builders Association in this state or any other state, canceled, suspended, revoked, or non-renewed for any reason? Yes No If yes, please fully explain the circumstances of the cancellation, suspension, revocation, or non- renewal of your membership, and provide the name and address of each applicable Home Builders Association you were formally a member. 2

4 Failure of an applicant to fully disclose any information requested in this application may be considered a material misrepresentation and may therefore be cause for rejecting an application for membership or revoking said membership if the material misrepresentation is discovered after the application is accepted and membership granted. Please give a brief history of yourself and your company. The information below may be edited and used in the On the Level HBA membership publication. By signing this application you are authorizing the Review Committee to contact the above references for additional information. I authorize the investigation of any and all statements contained in this application. I also authorize, whether listed or not, any person or entity to provide information and opinions that may be determined by the HBA to be relevant and useful in making a decision regarding my application for membership. I release the HBA and such persons and entities from any legal liability related to, or deriving in any manner from, their making inquiries, statements or decisions regarding my membership application. I understand that if the HBA decides to request an investigative consumer report from a consumer reporting agency regarding me and/or my company as part of the application process that I will be contacted by the HBA and requested to execute an additional acknowledgement form at that time. I understand that failure to comply with said request would preclude the HBA from completing its review of my application and result in denial of my membership application. In making this application, I agree to abide by the By Laws and Code of Ethics of the Home Builders Association of Fond du Lac & Dodge Counties, Inc., WBA and NAHB. My signature below also indicates I have received a copy of the Code of Ethics. This application is subject to the Board of Directors approval within 60 days of this application date. If this application is denied, a check for the application amount will be returned to the applicant. This Association does not discriminate in membership on the basis of race, color, religious creed, national origin, sex, or ancestry, on the basis of age, against persons whose age is between forty and sixty-five or against qualified handicapped persons or qualified disabled veterans or veterans of the Vietnam era. No question on this application is intended to secure information to be used for such discrimination. This application will be given every consideration, but its receipt does not imply that the application will be accepted. I agree to abide by the Constitution and By Laws of the local Association, to which the membership application is directed, of the National Association of Home Builders of the United States with which it is affiliated, and of the affiliated State Association. A remittance of $ is included. By signing this data sheet, I am hereby giving the Association and its subsidiaries and affiliates, including WBA and NAHB permission to transmit communications to my company and its staff using any company , telephone numbers, postal mailings, or facsimile numbers. The association also has my permission to put contact information on the Association website and in the membership directory. Representing my annual membership dues in the affiliated Associations accompanies this application. Of the amount remitted, a portion shall be used as subscription for one year to all national, state, and local newsletters. 3

5 Applicants (builders) who wish to participate in the 2013Parade of Homes tm must be in business one full year under the business name stated on this application prior to April 1, 2013 Sponsor (required) Applicant Signature Membership Requirements Builder Memberships are available to any person who is, or has been, in the business of building or rebuilding homes, apartments, schools, commercial, industrial, or other structures normally related and appurtenant to a community, or in land development, and who subscribes to the NAHB Code of Ethics and is of good character and business reputation. Associate Memberships are available to any person engaged in a trade, industry, or profession related to housing and not inconsistent with the objectives of NAHB or any of its affiliates; and who subscribes to the Code of Ethics and is of good character. Liability Insurance A certificate of insurance showing your liability insurance MUST accompany your application form. Return this Application to: Home Builders Association of Fond du Lac & Dodge Counties, Inc. 490 W. Rolling Meadows Drive Fond du Lac, WI Or fax back to: (920) ; also, info@homebuildersfdldodge.com NOTE: Dues payments to the Home Builders Association of Fond du Lac & Dodge Counties, Inc. are NOT deductible as charitable contributions for federal tax purposes. However, dues payments may be deductible as an ordinary and necessary business expense. Revised June

6 NAHB MEMBERSHIP INFORMATION REPORTING FORM CODES Member ID: Sponsor ID: Nickname: Member s Master ID Number (can be found on Monthly Membership Roster Report) Member s Master ID Number of the member to receive spike credit (can be found on Monthly Spike Club Roster) Name as it is to appear on badges and personalized mailing Business Activity Codes: Enter the member s most important business activities from the list of codes below (enter up to 3 different codes). Note: For other associate (Z), you must fill in the blank for Other business Classification if that member is to receive Builder Magazine. Builder Member Classification A Single Family Spec/Tract Building B1 Single Family General Contracting B2 Single Family Custom Building C Multifamily Building (Condo/Coop Units) D Multifamily Building/Ownership (Rental Units) E Multifamily General Contracting F Remodeling Residential Remodeling Commercial H Commercial Building (Own Account) I Commercial General Contracting J Land Development K Manufacturing of Modular/Panelized/Log Homes Wholesale Dealers/Distributor X1 Appliances X2 Building Materials/Lumber X3 Floor Coverings X4 Paint/Wall Coverings X5 Other Wholesale Dealership (specify) Associate Member Classification L Accounting M1 Architecture M2 Engineering M3 Planner or Designer N Legal Services O Computer Products & Services P1 Commercial Banking/Thrift Institution P2 Mortgage Banking Q Insurance or Title Company R Marketing, Advertising or Public Relations S Building Material Manufacturing T Property Management U Real Estate Y Utilities Z Other (specify) Subcontractors & Specialty Trade Contractors W1 Carpentry Work W2 Electrical Work W3 Masonry, Stone Work, Tile Setting, Plastering W4 Landscaping W5 Plumbing, Heating & Air Conditioning W6 Roofing, Siding, & Sheet Metal Work W7 Painting & Paper Hanging W8 Floor Laying & Other Floor Work W9 Concrete Work WA Excavation Work WC Land Surveyor WD Security System WZ Other Subcontractors (specify) Retail Dealers/Distributor V1 Appliances V2 Building Materials/Lumber V3 Floor Coverings V4 Paint/Wall Coverings V5 Other Retail Dealership (specify) Annual Dollar Volume: Enter the member s approximate annual dollar volume of new residential construction/development, using the following codes: 0. Under $500, $1 million to $4,999, $10 million or over 1. $500,000 to $999, $5 million to $9,999, No construction activity Annual Number of residential dwelling units built in past 12 months: Enter the member s approximated number of units built using the following codes: 1. 0 units to to to to Over 500 Total Paid Employees: Enter the total employees in the blanks provided. Include the member in your total figure. Business Title: Enter the code that best describes the member s business title, using the following codes: 1. President/CEO 5. Architect, Designer or Engineer 2. VP/General Manager 6. Financial Manager/Director 3. Construction Superintendent 7. Owner, Principal or Partner 4. Sales & Marketing Manager/Director 8. Other (specify)