Automotive Aftermarket Suppliers Association

Automotive Aftermarke Suppliers Association

AASA Affiliate Application (*Required Field)

Company Information
Company:
Street Address:
PO Box:
City:	State/Province: Zip:
Country:
Fax:	Corporate Phone:
Website:

Contact Information:

List the name and title of the company executive to be designated as your company's Member Representative (MR). (AASA strongly suggests that only a top-level executive be named.) The designated Member Representative will be AASA's primary contact with the company and will receive all association service and information mailings.

First Name:

Middle Name:

Last Name:

Title:
Phone:	Email:
Address:
PO Box:
City:	State/Province:	Zip:
Country:

AASA Affiliate Membership Eligibility/Dues:

Affiliate Membership
Any recognized company engaged in the automotive aftermarket may be admitted as an affiliate member under such conditions and with such rights and privileges as the Board of Governors determines but shall not have voting privileges.

*Annual Affiliate Membership

$3,000

Other Market Segment Interest

Heavy Duty Manufacturers Association (HDMA)

Original Equipment Suppliers Association (OESA)

Please check the types of services your company provides (check all that apply):

Consulting/Advisory
Products and/or Manufacturing
Outsourcing
Other Services

Area of expertise (Check all that apply):
Accounting/Finance	IT (Software, Hardware, E-commerce, Security, Networking)
Advertising/Marketing/Public Relations	Legal
Business Strategies (Operations, Management)	Logistics/Transportation/Warehousing
Education/Training/Learning Services	Market Research
General Business Services (Printing, Supplies, etc.)	Telecommunications
Healthcare	Testing/Quality Control
Import/Export Services	Tooling/RD/Engineering
IPR/Brand Protection	Other

Please provide a description of your organization and services (limit 255 characters):

Payment Options (Payment applied upon approval)

Invoice my company using Purchase Order Number:

Check Number: has been sent in the mail.

Charge to my credit card
Credit Card Number: Expiration Date:
Name on Card:

Acceptance of Terms

The above-named company hereby applies for affiliate membership in the Automotive Aftermarket Suppliers Association (AASA). Accompanying is our authorization to charge the indicated credit card for one year's dues, based on the category into which our company falls (as indicated in this application), or a P.O. is indicated or a check is in the mail.

We have read the "Eligibility Requirements" of this application and believe our company is eligible for membership. If approved for membership, the term of our membership is the remainder of the current calendar year, automatically renewable at prevailing membership dues and cancelable only with at least 30 days written notice. We also agree that, as members of AASA, we will abide by all of the association's bylaws. We understand membership may be terminated if dues payment is more than 60 days past due.

I have read and accept these terms and conditions of this application.

Signature: Check to Accept:

Click to Submit