1 Company Information (Please fill out as completely as possible)






2Type of Company (Choose the most appropriate category. If your business does not fit in a listed category, please choose "other" and describe.)
3Association Health Insurance: Does your company have interest in receiving information about the Association's health insurance plan?

Membership Dues: The formula for calculating dues is based on your total number of employees. This includes both full-time and part-time staff working in Utah. The fees are as follows:

Total Number of Employees

Association Dues

$

Number of Employees Annual Dues
1 to 10 - $400
11 to 500 - $400 plus $6.90 per employee over 10
501 to 1,000 - $3,830 plus $5.65 per employee over 500
over 1,000 - $6,725.00 plus $3.60 per employee over 1,000 up to a maximum of $20,000 per company.

If you would like other personnel in your organization to receive communications from the Association please send an email to membership@utahretail.com with the names, titles and email addresses of those individuals.