Membership Application National Trailer Dealers Association Membership Category and Annual Dues DEALER —Independent licensed dealers engaged in the business of buying and selling semi-trailers, or a representative appointed by such a dealer. Companies engaged principally in the business of purchasing semi-trailers, semi-trailer equipment, or component parts of such semi-trailers or equipment from manufacturers for resale to users and other dealers. $599 DEALER BRANCH(ES) — A branch office/location of an NTDA Dealer Member. Included with Dealer Membership. (Note: headquarters office must maintain active membership status.) ALLIED — Companies engaged primarily in the manufacture of semi-trailers and/or semi-trailer parts and accessories, and others that are not dealers or manufacturers but are affiliated with the semi-trailer industry and support the objectives of the Association. $799Today's Date* Referred by current NTDA member (optional)NTDA Primary Contact Information (Note: This person will be listed in the ntda database as the primary contact for your company.Membership-related correspondence and inquiries will be sent to his/her attention.)Username*Title*First Name*Last Name*Company*Address1*Address2City*State*ZIP*Country*United StatesCanadaMaxicoIndividual Email* Phone*FaxWebsite Dealer Branch Information If you are a Dealer and have branch locations, please e-mail the name of the branch manager or contact person for each branch location along with the branch address, phone and fax to NTDA President Gwen Brown at firstname.lastname@example.org, or upload a Word document that contains the Branch location information. There is no additional charge to list your Dealer Branch locations in the NTDA Membership Directory.FilePreferred Billing InformationCheck if same as above*YesNoTitle*First Name*Last Name*Address1*Address2City*State*ZIP*Country*United StateCanadaMaxicoBilling Contact Email* NTDA ByLaws & Antitrust Policy Click here to read the NTDA Bylaws Click here to read the NTDA Antitrust Policy* I have read the NTDA Bylaws and NTDA Antitrust Policy Contact Us: Questions? National Trailer Dealers Association 9864 E. Grand River Ave. Ste. 110-290 Brighton, MI 48116 Toll-free: 1-800-800-4552 Direct Dial: (810) 852-2501 Fax: (810) 229-5961 www.ntda.org Questions? NTDA President Gwen Brown at email@example.com.Payment InformationChoose membership category*Dealer Member Annual Membership ($599)Allied Member Annual Membership ($799)VISAMasterCardAmerican Express If you need to pay by check, print and mail application. Pre-payment required to activate membership. Credit CardCIV/Security CodeExpiration Date Name of CardCheck "Yes" if credit card address is same as primary contact person's mailing address. If you answered "No" please provide your credit card billing address below.*YesNoCard Holder NameAddress 1Address 2CityStateZIPCountryUnited StatesCanadaMexico This iframe contains the logic required to handle AJAX powered Gravity Forms.