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Southeastern Construction Owners & Associates Roundtable
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Member Update Form
Please complete and submit the form below to ensure that the member information we have on file is current.
Company
(Required)
Name
(Required)
First
Last
Title
(Required)
Company Website
(Required)
Email
(Required)
Enter Email
Confirm Email
Business Phone
(Required)
Cell Phone
Company Address
(Required)
Street Address
Address Line 2
City
State
ZIP / Postal Code
Are you still the official delegate (primary contact) for the company?
Yes
No, but keep me on SCOAR's email communications list and the online member directory
No. Please remove me from SCOAR's email communications list and online member directory.
If you're interested in serving or continuing to serve on one or more SCOAR committees, please select all that apply.
Workforce Development
Safety
Delegate Information
Name
Enter the name and contact information of the official delegate below:
First
Last
Title
Email
Business Phone
Would your delegate be interested in serving on a SCOAR committee?
(Check all that apply.)
Workforce Development
Safety
I'm not sure.
Additional Company Representative(s) Information
Please enter the names of a senior executive, a HSSE, workforce development, and business development professional below and let us know if they should be included on SCOARs online member directory and in email communications related to SCOAR events and activities.
Senior Executive - Include senior executive's contact information in SCOAR's distribution list and online member directory?
(Check all that apply.)
Yes, include contact information in SCOAR's email communications list.
Yes, include contact information in SCOAR's online member directory.
No, do not include contact information
Senior Executive's Name (If different from yours or your delegate's.)
First
Last
Senior Executive's Title
Senior Executive's Email
Phone
Would your Senior Executive be interested in serving on one of SCOAR's committes?
Safety
Workforce Development
Not Sure
HSSE Representative - Include contact information in SCOAR's distribution list and online member directory?
(Check all that apply.)
Include contact information in SCOAR's distribution list.
Include contact information in SCOAR's online member directory.
No, do not include information
HSSE Representative (If different from yours or your delegates.)
First
Last
HSSE Representative's Title
HSSE Representative's Email
Would your HSSE representative be interested in serving on SCOAR's Safety Committee?
Yes
No
Not Sure
Include WFD representative's email in SCOAR's distribution list and online member directory?
(Check all that apply.)
Include contact information in SCOAR's distribution list.
Include contact information in SCOAR's online member directory.
No, do not include information
Workforce Development (WFD) Representative's Name
First
Last
WFD Representative's Title
WFD Representative's Email
WFD Representative's Phone
Would your WFD representative be interested in serving on SCOAR's WFD Committee?
Yes
No
Not Sure
Include Business Development representative's email in SCOAR's distribution list and online member directory?
(Check all that apply.)
Include contact information in SCOAR's distribution list.
Include contact information in SCOAR's online member directory.
No, do not include information
Business Development Representative's Name
First
Last
Business Development Representative's Title
Business Development Representative's Email
Phone
Would your Business Development representative be interested in serving on a SCOAR committee?
(Check all that apply.)
Workforce Development
Safety
Not sure
Additional Representatives
If there are others in your company who are currently involved in SCOAR or need to be added to your member list, please enter their information below:
Name
Address
Email
Phone
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Untitled
Provide a 2-3 sentence description of your company, highlighting what you do and the unique value you bring to our organization. We would also be interested in the value-add SCOAR provides your company. Please note that your comments may be used for marketing purposes.
Invoicing Contact
Should SCOAR invoices be sent to your attention?
Yes
No
Send emails to our Billing Agent and copy me.
Billing Agent's Name
Please enter the name of the agent who should receive invoices from SCOAR.
First
Last
Email
Please provide the agent's email.
Phone
Please provide the agent's phone number.
Company Logo
Please upload a high-resolution version of your company logo to post on our site and to recognize your company in email communications, social media, and other activities.
Accepted file types: jpg, jpeg, png, gif.
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