Contractor Membership Application | IECRM | Independent Electrical Contractors Rocky Mountain

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Name

This field is for validation purposes and should be left unchanged.

Company Name*

Company Phone Number*

General Business Email (i.e. [email protected]) or your main/default email for invoicing, communications, etc.

This email address will receive all billing notifications.

Please provide your company's Employer Identification Number (EIN)*

Business Address*

Street Address Address Line 2 City State ZIP Code

Business Fax

Business Website*

Name of Primary Contact*

First Last

Title*

Email*

Business Phone*

Primary Contact Direct Line

Primary Contact Cell Phone

About Your Company

What is the primary office location of your company?*

Please list any additional locations (headquarters, administration, or satellite locations):

What year was your company founded?*

Colorado / Wyoming State License #*

Master Electrician Name*

Master Electrician License #*

Worker's Compensation Provider*

Is your company (check all that apply):

Certified Green Business

Woman-Owned Business (WBE)

Minority-Owned Business (MBE)

Veteran-Owned Business (VBE or VOSB)

Business owned by economically disadvantaged individuals (DBE)

Business owned by LGBT individuals (LGBTBE)

Do you bid on Davis-Bacon / Government Contracted Projects?*

Yes

Do you anticipate sending your 3rd and 4th-year apprentices to school?*

Yes

Do you have an internal safety program in place?*

Yes

About Your Work

What percentage of your work is in Colorado?*

Please enter a number from 0 to 100.

What percentage of your work is in Wyoming?*

Please enter a number from 0 to 100.

In addition to Colorado, in which other states do you perform work?

In which Colorado counties do the majority of your work take place?*

Please select the categories of work projects your company engages in:*

Residential

Commercial

Light Industrial

Industrial

Heavy Industrial

Institutional / Municipalities

Low Voltage

High Voltage

Utilities

Energy / Renewable Energy

Highway / Transportation

Mechanical

COMMERCIAL

Restaurant / Food Service

Entertainment / Sports / Gaming / Recreation

Financial (Banking / Insurance)

Retail Stores (all types)

Office Buildings

INSTITUTIONAL / MUNICIPALITIES

Healthcare / Hospital / Nursing Home

Education (K-12 / College / University)

Religious

Government Admin (Fed, State, Local) / Law Enforcement / Correctional / Military

Transportation (Airport / Rail / Other)

Infrastructure

INDUSTRIAL

Manufacturing Plants

Power Generation / Utility

Oil / Gas / Mining

Road / Airport / Traffic Lighting / Line Work

Waste / Water Treatment, etc.

Agriculture

RESIDENTIAL

Single

Multi-Family

Hotel / Resort

ENERGY

Oil / Gas / Mining

Solar PV

Wind

EV Charging

LOW VOLTAGE

Security (includes CCTV, Access / Motion / Intrusion Systems)

Fire / Life Safety Systems

Building Automation

Fiber Optics

Communication Systems (Voice / Video / Data)

Please select the Building Components & Services your company has installed:

Maintenance / Service / Repair Only

Maintenance / Service / Repair

Design / Build Services

Pre-fabrication / Manufacturing

Premises Wiring

Alternative energy systems (Solar, Wind, EV charging)

LED lighting retro-fit and design

Power Quality Systems (Standby, Co-gen, etc.)

Security (includes CCTV, Access / Motion / Intrusion Systems)

Fire Life Safety Systems

Total Building Automation Systems (HVAC, Lighting)

Fiber Optics

Communication Systems (Voice / Video / Data)

Other

What are the largest challenges that you face in your business that you feel IECRM can help you overcome?*

How did you hear about IECRM membership? Who can we thank for referring you?*

Tell us more about your company.

Please designate a secondary contact to receive communications from IECRM:

Secondary Contact's Name*

First Last

Title*

Email*

Phone*

Please designate a Main Education Contact name, phone, and email that will be responsible for registering students, tracking OJT hours, grades and attendance.:

Education Contact's Name*

First Last

Title*

Email*

Phone*

Please list the names and titles of additional company owner(s) and officer(s)

Name

First Last

Title

Phone

Name

First Last

Title

Phone

Please list the names and titles of additional company contacts:

Accounting Contact

Accounting Contact's Name*

First Last

Title*

Email*

Phone

HR/Benefits

HR Contact's Name

First Last

Title

Phone

Business Dev/Mktg

Name

First Last

Title

Phone

Training

Training Contact's Name*

First Last

Title

Email*

Phone

Estimating

Estimating Contact's Name

First Last

Title

Phone

Project Manager

Project Manager's Name

First Last

Title

Phone

Safety

Safety Contact's Name

First Last

Title

Phone

Total number of employees in the Rocky Mountain Region (Denver metro, Northern Colorado, Wyoming)*

Total number of direct labor hours for the previous year reported on your OSHA 300 form.*

Total # of Electrical Field Workers (Including Master Electrician, JWs, and Apprentices)*

Of the total number of electrical workers, how many are or will be apprentices in the Rocky Mountain Region (Denver metro, Northern Colorado, Wyoming)*

On average, how many NEW apprentices do you hire annually?*

Billing preference*

Your membership is an annual commitment. Dues payments will be set up on autopay via credit card or ACH. The first six month payment is taken up front, then you can switch to monthly, quarterly, or annual payments. Dues will be processed automatically each cycle.

The above rates are a combination of monthly dues for IECRM Chapter and IEC National membership. The first six months of dues is required for onboarding. PLEASE NOTE: 6 months of monthly dues and a one-time application fee of $75 is required to initiate membership. Once membership is established, dues may be paid monthly, quarterly, or yearly.

What is your company’s current gross annual revenue?

Do you utilize temporary staffing companies? If so, did you utilize temporary staffing companies in the last 12 months?

IECRM Committees provide the voice of our industry. We welcome new committee members for IECRM members in good standing. Please indicate your interests and you will be contacted with more information about the committee.

Events

Government Relations

Membership

Safety

Workforce Empowerment

Emerging Leaders

Is your company on social media?

Facebook

Twitter

Instagram

At IECRM, safety is at the core of everything we do. We believe that every electrical professional deserves to return home safely at the end of each day. By promoting best practices, providing safety education, and fostering a culture of awareness and accountability, IECRM helps ensure the well-being of our members, apprentices, and the communities we serve. A strong commitment to safety not only protects lives—it strengthens the integrity and professionalism of our entire industry. Please take a moment to complete our online safety evaluation.

IECRM Safety Evaluation

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About Your Company

About Your Work

Tell us more about your company.

Accounting Contact

HR/Benefits

Business Dev/Mktg

Training

Estimating

Project Manager

Safety

Contact IECRM

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About Your Company

About Your Work

Tell us more about your company.

Accounting Contact

HR/Benefits

Business Dev/Mktg

Training

Estimating

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Safety

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