Annual Dues Schedule

Active Member (Product/Supplier of

Asphalt Cements, Cutbacks, or related Products)                   $900.00

Associate Membership                                                            $500.00

Engineers, Consultants or Testing Laboratories                      $150.00

Enclosed is payment in the amount of:   $___________________________.

Company Name:______________________________________________.

Please submit form and payment to Steve Fulk at the address below.

(PAAMA EIN # 23-7348334)