Associate Member Application Associate Member Application Company Name(Required) Mailing Address(Required) Address Address Line 2 City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Contact Name(Required) First Name Last Name Main Phone(Required)FaxWebsite Email(Required) untitled Yes – Please Link My Company’s Website To The MMDA’s Website Contacts(Required)TitleNamePhoneEmail Add RemoveAdd more contact rows by clicking the Plus (+) symbol at the end of the line.MMDA Associate Membership Dues (Invoices for dues are sent out separately) Dues$840.00 GST$42 Total$882 Consent(Required) I agree to renew membership in the Manitoba Motor Dealers Association and agree that we will abide by the rules and regulations of the Association.(Required)