Membership
Print or type
Company Name: _______________________________
Mailing Address: _______________________________
_______________________________
_______________________________
Telephone:__________________Fax:__________________Cell:_____________Pager:___________ Email:__________________________________________
Owner's) Name:__________________________________________________________
Primary contact IF other than owner:_______________________________________
Type of equipment (Resource list for mutual aid purposes & networking optional attach additional sheet if needed) __________________________________________________________________________
__________________________________________________________________________
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__________________________________________________________________________ Do you belong to another Towing industry? association:__________________________
If yes, please list association name's):________________________________________
___________________________________________________________________________
Does your company offer 24 hour towing/recovery Services? Yes or No
Does your company offer 24 hour road service? Yes or No
Annual Dues $100.00
All dues are payable by May 31st of each year. To avoid being removed from member lists and benefits
please remit in a timely manner. Thank you
Additional information/Comments:________________________________________
________________________________________________________________________
________________________________________________________________________
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