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NORTH CAROLINA MOTORCOACH ASSOCIATION
106 Main Street, Brookneal, VA 24528
336-495-4970 FAX 336-495-5833
Membership Application and Directory Information
Name of Company: __________________________________________________
Address:__________________________________________________
City: _____________________________ State: _____ ZIP: ____________________
Telephone (list all extensions desired in the directory):
_____-_____-_______ _____-_____-_______ FAX:_____-_____-_______
Email: ________________________ Web: __________________________
Mailing Address, if different from address above:
________________________________________________________________________
List key personnel to be included in the directory:
NAME TITLE HOME TELEPHONE
________________________ ___________________ ____________________
________________________ ___________________ ____________________
________________________ ___________________ ____________________
________________________ ___________________ ____________________
Check the items listed below that apply to your company:
A ___ Regular Route Carrier E ___ Own and Operate Maintenance Facilities
B ___ Charter Coach Operator F ___ Intrastate (NC) Operators Only
C ___ Package Tour Operator G ___ Intrastate and Interstate Operations
D ___ Bus Express Carrier
Number of coaches operated ____ Periodic mailings to (number) _______ customers.
Date Business Was Started: _____________________________
Requirements for membership:
1. Completed Application Form
2. Check in the Amount of $250 payable to NCMA
3. Two letters of recommendation from current operator members
4. Signed Code of Ethics
5. Proof of Insurance (copy of insurance certificate)
6. Copy of Operating Authority (out-of-state). Must be certified for at least one year.
7. Affirmative Vote by the NCMA Board of Directors
NCMA FEDERAL I.D. NUMBER: 56-6062854