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Toledo Trucking Association |
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131 Matzinger Rd. |
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Toledo, Ohio 43612 |
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www.toledotrucking.com
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Membership Dues & Registration Form |
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| Company Name: |
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| Contact: |
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Job Title: |
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| Physical Address: |
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| City: |
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State: |
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Zip: |
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| Mailing Address: |
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| City: |
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State: |
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Zip: |
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| Phone: |
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Fax: |
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| E-Mail: |
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Website: |
http:// |
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| **Please list additional contacts for your company on the back of this form. |
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| Industry (Check all that Apply) |
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Allied Industry |
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Common Carrier |
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Truck Dealer |
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Contract Carrier (For Hire) |
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Engine Distributor |
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Private Carrier |
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Insurance |
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Local Cartage/Dryage/Whsg |
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Financial |
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Broker |
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Tires |
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Towing/Salvage |
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Truck Rental |
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Bulk Carrier |
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Management Services |
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Household Goods |
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Government Agencies |
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Oversize |
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Service & Repair |
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Other (list) |
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Alignment |
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Other (list) |
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| Industry Equipment Type |
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Fleet Size |
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Dry Van |
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Straight Trucks |
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1-10 |
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Flatbed Trailers |
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Cargo Vans |
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11-50 |
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Tanker Trailers |
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Specialized Equipment |
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51-100 |
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Refrigerated Trailers |
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Bulk Trailers |
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101-200 |
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Dump Trailers |
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201+ |
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| Industry Organization Memberships (Check all that apply) |
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A.T.A. |
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Truck/Trailers Manufacturer's Assoc. |
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O.T.A. |
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Ohio Tire Dealers & Retread Assoc. |
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T.C.A. |
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National Trailer Dealers Assoc. |
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American Truck Dealers Assoc. |
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Other (List) |
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Page 1 of 2 |
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| Are you a V & A Risk Services Member? |
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Yes |
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No |
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| Are you interested in being further involved in any special committees with the TTA? |
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Yes |
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No |
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| *If Yes, please mark what you would prefer to volunteer for: |
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Golf Outing |
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Annual Reception |
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Christmas Party |
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Meeting Presenter |
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Safety Days |
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Other:______________________________ |
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| Would you like your company & contact information to be posted on the TTA Website, accessible to the public? |
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Yes |
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No |
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| Please note that our Monthly Newsletters will be emailed to the specified contacts) listed. |
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| TTA recipients may receive multiple copies of TTA notices - please make sure respective |
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| individuals & email address are enclosed. |
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| Your information is for Toledo Trucking Association use only. TTA will not provide your |
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| information to any third party source. |
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| Company Membership dues are $60.00 |
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| IN ADDITION - Our company would like to make an optional donation to the |
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| Toledo Trucking Association/University of Toledo Annual Scholarship fund |
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$25 |
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$50 |
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$75 |
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$100 |
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Other $__________________________________ |
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| Please make all checks payable to Toledo Trucking Association |
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| Mail dues payment and/or Scholarship donation along with this Registration form to: |
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| Toledo Trucking Association |
|
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| 131 Matzinger Rd. |
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| Toledo, Ohio 43612 |
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Page 2 of 2 |
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