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& Recovery Association, Inc. |
MEMBERSHIP
APPLICATION
Company:_____________________________________________________________________
Phone:_____________________Fax:__________________E-mail:_______________________
Address:________________________________City_______________State_____Zip________
Company
Type: _____ Corporation _____ Partnership _____ Sole Ownership _____ Other
Number
of Employees: ________
Number
of Trucks by Class: _____ Light _____ Medium _____ Heavy
Representative: _______________________________Title:_____________________________
Owners and/or Corporation Officers Position/Title
1.____________________________________________________________________________
2.____________________________________________________________________________
Membership Dues/Membership Class
Associate Member $240 _____
State Member $240 plus $25 per Truck_____
I understand that this application is subject to approval
by the Board of Directors of the association; and, if not accepted, my payment
will be refunded in full. Until such time, I shall be designated as a member-applicant.
If elected to membership, I pledge to conform to the Articles, By-laws and other acts of the Arizona Professional Towing and Recovery Association.
Signature: ______________________________
(For Association Use)
Company Name: ________________________Assoc.________________State__________
Amount Paid__________________ Method of Payment _______________Date__________
Authorized APTRA signature_________________________________________________
Please remit application to: APTRA,