Tri-State Automatic Merchandising Council

TRI-STATE ONLINE APPLICATION

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I hereby apply for membership in the TRI STATE AUTOMATIC MERCHANDISING COUNCIL and if accepted into membership, agree to abide by the Bylaws set forth by the Association and Acts pursuant thereto.
*	Individual's Name:	*	Company Phone:

*	Company Name:		Company Fax:

*	Company Street Address:	*	Individual's Email:

*	City:	*	Confirm EMail:

*	State:		Referred By:

*	Zip:
		*	REQUIRED FIELD
We agree to pay dues annually on the dues schedule establised by the Council as follows:
	...Operator Member
	...1-3 Employees	$330.00 per year $425.00 per year $560.00 per year $685.00 per year $700.00 plus $200.00 per branch
	...4-15 Employees
	...16-50 Employees
	...51+ Employees
	...Multi-branch Operating Companies
	...Associate Member
	...$375.00 per Companygdfg
By signing this application and paying my dues, I agree to allow myself and my business or company to receive notices, advertisements, announcements, brochures, and other information from Tri-State, the National Automatic Merchandising Association (NAMA) and its foundation via facsimile, telephone or email. I further agree that my express permission to fax, telephone or email me such notices and other information will continue with no date of expiration.
*	Signed:	*	Date:

*	Title:		If paying online, do so first. Then...

PAY BY MAIL... PLEASE MAKE CHECK PAYABLE TO: Tri-State AMC 449B Carlisle Drive Herndon, Virginia 20170 THIS MEMBERSHIP APPLICATION IS SUBJECT TO APPROVAL BY THE BOARD OF DIRECTORS AND IS NOT APPROVED UNTIL NOTIFIED BY THE ASSOCIATION.

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A State Council of National Automatic Merchandising Association

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