Enter all the fields below. Print the form if mailing payment or pay online using Paypal. Name Title Company Address City State AL AK AZ AR CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Phone Cell Fax Email LSU Graduate? Yes No Year Committee preference (please check): Curriculum & Accreditation Department Enhancement Finace & Governance Membership & Fundraising Publicity & Promotion Student Enhancement Dues: $1000 for each REGULAR Member (Contractors and Owners) $500 for each ASSOCIATE Member (Suppliers and Service Companies) $50 for Jr. Membership (Graduate of LSU CM Program in last 12 months) $250 for Jr. Membership Program (1st July of Jr. Membership Program) $250 for Jr. Membership Program (Final year of Jr. Membership Program)       *Jr. Members must actively work on a committee I recommend contacting      with     to become a member of CIAC. His / Her contact number is   . Address:                         If you prefer to pay by check,  please print the application and make checks payable to "Construction Industry Adivsory Council". Mail To: Construction Industry Advisory Council P.O. Box 14902 Baton Rouge, LA 70898 Pay by Paypal: