*Company Name
*Contact Full Name
*Title
*Mailing Address
*Mailing Address (cont.)
*City
*State
*Zip/Postal Code
*Work Phone
*Mobile Phone
*Fax
Do you have a website?	Yes     No
Website Address:

*Email (Must be a valid Address:)
*Choose a Username - Do not use inappropriate, unprofessional, or fictitious names. They will be edited by the forum administrator.	(No Spaces)
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*Birthday (Only so we can verify over 18 and wish you a happy birthday!)	Format:  01/09/1955

Which of these types of roofing do you install?:

Flat Roof
Metal Roof
Shingle Roof
Other
 

Which of these types of roofing do you install?:

Residential
Commercial
Industrial
Institutional
 

How many employees do you have ?

Indicate the range of annual sales for your company.

$0-$250,000
$250,001 - $500,000
$500,001 - $1,000,000
$1,000,000 - $2,000,000
$3,000,000 - $5,000,000
Above $5,000,000
 

Please tell us a little more about you and your company -

Please tell us how you heard about us:

Please Select One TradeShow RoofingChannel.com Received Email Internet Search Member Referral RooferData.com Postcard Other

If a current NRG Member referred you, please let us know who it was here:

Do you belong to any roofing related organizations? Please list:

Your registration gains you full access to the following sites. Your username and
password will be the same for each of our sites. Please un-check any sites you do not
wish to use:

Roofer's Auction:             RoofingChannel.com:            FusionPrinting.com: 

    Roof Campus:         NRG Members Only Site:           NRG Roofing Forum: 

Note: As an NRG Member Contractor, your company information will automatically
be entered into the RooferData database. This will allow customers in your area to find
your company more easily. For more information on your free listing, please visit:
www.rooferdata.com