Please complete the following information for the primary contact for your organization. Your membership fee of $95.00
includes one copy of any correspondence including the monthly minutes to be sent to this individual:
COMPANY NAME: ____________________________________________________
PRIMARY CONTACT: ______________________________________________________
ADDRESS: ________________________________________________________________
CITY: ______________ STATE: ______ ZIP CODE: ___________
TELEPHONE: ______________________________________________________________
FAX NUMBER: _____________________________________________________________
EMAIL ADDRESS: __________________________________________________________
NUMBER OF EMPLOYEES/MEMBERS: ______________________________________
HOW IS PEAA INFO DISTRIBUTED TO EMPLOYEES: ____________________________________________________________________________
Please return this form with your check payable to PEAA.
Send to: Chris Sterf
PPG Industries
One PPG Place
Pittsburgh, PA 15272
