Better Fuel Mileage
Classic & Custom
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MEMBERSHIP APPLICATION |
2011 Membership Application
New England Tire & Service Association
PO Box 1012
Yarmouth, ME 04096
Tel(207)846-0986, Fax(207)846-0987
Primary Membership: $ 249
Additional Locations: $ 35 each
10 or more locations is $549
Company Information (Primary)
Business Name_____________________________________________________________________
Street Address______________________________________________________________________
City/Town__________________________________State________Zip Code__________________
Contact Person__________________________________________Title_______________________
Business Tel #___________________________Business Fax #___________________________
Email Address______________________________________________________________________
Web Site Address__________________________________________________________________
Are you applying as:
____An Independently owned business selling tires and/or mechanical service:
___Retail ___Wholesale ___Commercial
____Supplier Member: Describe what products/services you provide___________________
____________________________________________
____Other ________________________________________________________________________
Total Number of Locations applying? Primary = $ 249
(Please supply information for additional locations on a separate sheet)
Additional ______X $35 = $ ____
Check Enclosed________ Bill Us Please _______ Total Dues = $ __________
Credit Card #_____________________________________Expiration Date_____________
Member Pledge
“As a NETSA member, I pledge to abide by its bylaws & to conduct my business in a fair & reputable way.”
_______________________________________ Date_________________
Signature
New England Tire and Service Association
Dick Cole, Executive Director
Mail: PO Box 1012, Yarmouth, Maine 04096
Phone: 207-846-0986 E-Mail