Arizona Propane Gas Association

2017

RETAIL MARKETER MEMBERSHIP APPLICATION

Please type or print clearly.

Company Name:
Physical Address:
City: / State: / Zip Code:
Phone: / Fax:
E-mail: / Web URL:
Mailing Address:
City: / State: / Zip Code:
Phone (if different): / Fax (if different:
Accredited Representative: / Title:
Cell Phone: / Email:

Dues are calculated based on the number of a company’s “bulk plants” as defined by the 2004 edition of NFPA 58. The NFPA 58 standard defines “bulk plant” as: “A facility where the primary function is to store LP-Gas prior to further distribution. LP-Gas is received by cargo tank vehicle, or pipeline, and then distributed by portable container (package) delivery, by cargo tank vehicle, or through gas piping.”

Member Classification
Is the address listed above: / Membership Dues
Includes membership in the
Colorado Propane Gas Association and
National Propane Gas Association
□Bulk Plant Only
□Retail Location Only
□Bulk Plant & Retail Location
□Check here if bulk plant is
also retail location and should
be listed in NPGA’s Membership
Directory. / □Headquarters Only
□Check here to list HO in NPGA
Membership Directory.
□Office Only
□Check here to list Office in NPGA
Membership Directory. / Your company’s total number of bulk plants: ______
Membership Dues :
□0-2 Bulk Plants (combined price) or Headquarters: $853
□3-5 Bulk Plants $1448
□Over 5 Bulk Plants $556 per plant
over 5

ADDITIONAL RETAIL OUTLETS OR BULK PLANTS (use additional sheets if necessary)

Primary Contact: / Primary Contact:
Company Name: (if different than above) / Company Name: (if different than above)
Mailing Address: / Mailing Address:
City, State, Zip: / City, State, Zip:
Physical Address: / Physical Address:
City, State, Zip: / City, State, Zip:
Phone: / Phone:
Fax: / Fax:
E-mail: / E-mail:
Bulk Plant Only
Retail Location Only
Bulk Plant & Retail Location
Check here if bulk plant is also retail locationand should
be listedin NPGA’s Membership Directory. / Bulk Plant Only
Retail Location Only
Bulk Plant & Retail Location
Check here if bulk plant is also retail locationand should
be listedin NPGA’s Membership Directory.

Please return to:

Arizona Propane Gas Association

18057 West 78th Dr. Arvada, CO 80007

Phone: 303 424-0870 Email: