Membership & Renewal Form

Membership Dues Application/Renewal

 

Dues are for July 1, 2013 to June 30, 2014. Paid Members receive a discount to the yearly USPA conference.
This year's conference will be hosted by Colorado State University in March 2014.

Please check membership type –

 

 $50 Individual Membership
 

  $75 Institutional Membership (Two to four individuals from the same college or university)
 

$100 Benefactor Membership (Five or more individuals from the same college or university)

 

$300 Supporting Vendor ($200.00 for vendors who are renewing support from the previous year)

      

 If paying by CHECK, please make check payable to USPA and mail dues form and check to:

   University Surplus Property Association (USPA)  
   ATTN: Clifton Grindstaff

University of Utah

University Surplus and Salvage
210 Connor Street

Salt Lake City, Utah 84113

 

If paying by CREDIT CARD, please mail dues form to the above address or fax to:
ATTN: Clifton Grindstaff at (801) 585-3051.
Do not email credit card information for security reasons.
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School or Company Name:

 

 

Method of Payment:


  Check  (Check No:_____________)   Visa   MasterCard
        

The below listed cardholder authorizes payment and acknowledges this with their signature.

 

Name of Cardholder:

 

Signature of Cardholder:

 

Credit Card Number:

 

Expiration Date:

                                                                      Credit Card Billing Address:

 

School/Company:

 

Street/Mailing Address:

 

City/State/Zip:

 

Telephone:

Email:


Please list names of individuals covered under an Individual Membership, Institutional Membership,
Benefactor Membership or a Supporting Vendor category:

Name:

Title:

Department Name:

Street/Mailing Address:

City/State/Zip:

Telephone:

Email:

 

Name:

Title:

Department Name:

Street/Mailing Address:

City/State/Zip:

Telephone:

Email:

Title:

 

Name:

Title:

Department Name:

Street/Mailing Address:

City/State/Zip:

Telephone:

Email:

 

Name:

Title:

Department Name:

Street/Mailing Address:

City/State/Zip:

Telephone:

Email:

 

Name:

Title:

Department Name:

Street/Mailing Address:

City/State/Zip:

Telephone:

Email: