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NORTH CAROLINA MOTORCOACH ASSOCIATION
106 Main Street, Brookneal, VA 24528
336-495-4970  FAX 336-495-5833
  

APPLICATION FOR ASSOCIATE MEMBERSHIP

Please complete information in type or print.  Forward the application along with a check in the amount of $200 made payable to NCMA, two letters of recommendation from current members of NCMA and signed Code of Ethics.  Mail to the above address.

As a supplier and/or vender to the bus industry, we/I hereby apply for active Associate Membership in the North Carolina Motorcoach Association.  By signature I certify that I have been engaged in a business which supplies products or services of interest to operator members of NCMA for at least one year and that I do not own a motorcoach. 

Company Name: ________________________________________________________

Mailing Address: ________________________________________________________

City: _____________________________       State: _____    ZIP: ____________________

Telephone:  _______________________        FAX:  __________________________

Email: _______________________              Web: __________________________

  Category for Directory Listing: (Check the category that best describes your business and write cross reference (CR) next to any other category that describes your business.)     

___Attraction      ___Hotel                 ___Restaurant           ___Sales, Service, Products   

___Theatre        ___Tour Receptive    ___Tourism Agency 

List representative(s) who are to be listed as company contact(s) in the Directory and will be active in the North Carolina Motorcoach Association.* 

Name                                                                         Title

___________________________________                 ________________________________

___________________________________                 ________________________________

List key representative and correct mailing address for the individual who should receive all NCMA correspondence:

Key representative:  ________________________________________________________

Mailing address: ________________________________________________________

City: _____________________________       State: _____       ZIP: ____________________

Telephone: _______________________         FAX: __________________________

Annual Membership Fee: $200

Membership benefits include Associate Member’s admittance to a “deluxe vendors’ hospitality suite” and
Market Place sessions during the NCMA annual meeting and one listing* in the NCMA Membership Directory that is distributed to all members. 
Annual meeting registration materials are sent to members only. 

Signature:    _______________________________________        Date:  ______________
                        (Applicant Representative)

Additional listings (for other locations, etc.) may be included in the directory at a cost of $50 per listing. 

NCMA FEDERAL I.D. NUMBER: 56-6062854