MHAPP Transporter Application Form

MHAPP Transporter Application Form
Company Name*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Main Email*
info@example.com
Company Website*
Company Principal*

First NameLast Name
Company Principal Title*
Company Principal Email*
Other Location Address:
Number of years involved in industry*
What type of product/service do you provide?*
Which modular industry players are you presently doing business with?*
Signature*

Clear
Name*

First NameLast Name
Company History
Brief description of company in 50 words or less (which may from time to time be used in Association publications):
Association Reference (if applicable):
Company Name
Contact Name

First NameLast Name
Phone Number
Email
example@example.com
FEES

The current year’s membership fee is $200.00. Payment is to accompany this application. Membership is based on the calendar year.

*A membership applies to one location only.

Transportation Member Definition/Requirements
- Shall abide by the Bylaws, Code of Ethics and Rules and Regulations of the Association.
- Shall be encouraged to participate in Association programs and surveys as required.
- Shall have proper liability and cargo insurance.
- All equipment shall have current certification.
- Shall have proper motor vehicle license classification and permits.
- I have read the Rules and Regulations outlining description of each membership category and agree our Association qualifies for membership under our current category.
- I have read the Bylaws, Code of Ethics and agree to abide by the same.
The Board of Directors of the Association has the right to refuse this application or request additional information. Should this application be refused, the membership fees shall be returned to the applicant without interest applied.
PUBLICATION

In submitting this application, you affirm that the company information is accurate, and you consent to its use for such purposes as promotion of membership, government liaising, public education, new products and services, intent information, and networking at all levels, Local, Provincial and National. Further, you acknoledge that approval of membership is subject to the Memerbship Definiftion and approval by the Association.
Signature of Applicant*

Clear
Name of Applicant*

First NameLast Name
Thank You for Your Support of the Association!

My Products

Transporter MembershipTransporter Membership

$200.00CAD

Subtotal

$0.00CAD

Tax

$0.00CAD

Total

$0.00CAD

Credit Card

GST Registration # R 10766 2504 RT0001
Should be Empty:

MHAPP Transporter Application Form

Company History

Association Reference (if applicable):

Credit Card