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NETSA Past Presidents |
2011 Trial Membership Application
New England Tire & Service Association
PO Box 1012
Yarmouth, ME 04096
Tel(207)846-0986, Fax(207)846-0987
New Members Only
Trial Membership thru 2011 - $39.00
(No Voting Rights & Can’t Apply for NETSA Scholarship)
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:
____Supplier : Describe what products/services you provide____________________________
____________________________________________
____Other: ________________________________________________________________________
Total Number of Locations applying? Primary = $ 39
(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 Trial Member, I pledge to abide by its bylaws & to conduct my business in a fair & reputable way.”
_______________________________________ Date_________________
Signature
Trial Membership does not provide for serving as an officer or director & does not provide for a vote on any Association issue.
New England Tire and Service Association
Dick Cole, Executive Director
Mail: PO Box 1012, Yarmouth, Maine 04096
Phone: 207-846-0986 E-Mail Fax(207)846-0987
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