Membership Application

Please complete and submit the application form below, then follow
the instructions on the next page to submit payment by check or credit card.

If you prefer, print the application form and mail with your check:
Mail-In Application Form

Business Information






Area Code/Phone




To keep all our members informed, RIICA would like to know how you would like to receive the monthly newsletter:


 By Email          By Mail



Membership Level

Individual/General Membership   $180.00
Standard membership privileges



Company Membership   $270.00
Includes membership for Owner/President/CEO and one (1) employee. The two members are entitled to all privileges and rights as Individual/General Members including the right to vote.

Owner Name

Employee Name (list one)



Qualified Company Membership   $50.00 each
(Company Membership Required)
This member must be an employee of a Company Member in good standing (dues paid in full). This member would not have voting rights. They or their family members would not be eligible for the RIICA Scholarships. They would receive all mailings and would be able to attend any and all meetings, classes, and functions at the same cost as regular members. Company members would be listed separately in directory; Qualified Company Members would be listed under the company.

Employee Name(s)



Associate Vendor Membership   $500.00

  • E-News advertisement throughout the year rotating RIICA website
  • Website link from the RIICA website including your logo and company information to your site at a click of a button
  • Advertising and sponsorship opportunities in the newsletters, special events and general membership meetings
  • Discounted rates for educational and safety seminars and events for all your employees



Youth Member   $25.00
No voting rights. Must be under the age of 18 years. Would be encouraged to help out with events when needed.



Payment Method



I will pay by: 

 Check          Credit Card or PayPal




© Copyright 2007-2024 Rhode Island Independent Contractors & Associates. All rights reserved.
PO Box 233 Exeter, RI 02822 (401) 785-1830
RIICA is a 501(c) 6 non-profit organization.


joomla 1.5 stats