International Playground Contractors Association (NPCAI) Membership & Qualified Contractors Application
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City______________________________________________ State________________ Zip ________________________
Telephone_____________________________________________ Toll Free_____________________________________
Fax ________________________________ E-mail _________________________________________________________
Business Type: ____ Sole Proprietor ____ Corporation _____ Partnership
Are you licensed to do business in your City/State? ____ Yes _____ No
Names & Emails of Owner(s), Partners(s), or Officer(s) of Organization________________________________________
Names & Emails of persons authorized to represent your Organization with NPCAI _______________________________
State(s) Licensed in: (must be current) _______, _______, _______, _______, _______, _______, _______, _______,
Please submit this application with the following (all items must be received before qualified contractor status can be achieved)
Copies are required and must be current.
What type or style of equipment does your organization typically work with. (in-ground field structures, soft modular,
residential wood units, aquatic playgrounds, safety surfacing, etc.)?
Do you sell playground equipment? □ Yes (if, yes which manufacturers?) □ No
____________________, ____________________, ____________________, ___________________, ____________
How many play structures has your organization constructed in the past 12 months? ___________________
Are you willing to serve on an association committee? □ Yes □ No
Are you willing to serve on the Board of Directors? □ Yes □ No
As a supporter of the NPCAI, what are the biggest concerns about the playground industry facing your organization?
I hereby make application for a membership in the International Playground Contractors Association on the basis of
the foregoing statements. I certify that the foregoing statements are correct. I will support the mission statement of the
International Playground Contractors Association as long as I continue as a member. Member’s dues are per
calendar year, payable in advance. Cancellation of membership requires written notice within 10 days of renewal.
We do accept Visa and MasterCard for payment and a $3.95 processing fee is applied.
□ Check # _____________________ □ Credit Card # __________________________________ Exp: __________
Firm Name ______________________________________________________________________________________
Name _________________________________________________ Title_____________________________________
Signature ______________________________________________ Date _____________________________________
For a twelve month membership, enclose checks payable to NPCAI:
We do accept Canadian checks.
International Playground Contractors Association (NPCAI)
Post Office Box 2364, Salt Lake City, Utah 84110-2364
Toll Free: 1-888-908-9519 · Fax: 801-355-2788