Associate Member Application Associate / OAS 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)FaxEmail(Required) untitled Yes – MMDA may use our company’s logo for promotional purposes. Upload Logo(Required)Max. file size: 256 MB. How You Can Help the Automotive Community(Required)Contact(Required)TitleNamePhoneEmail Add RemoveAdd more contact rows by clicking the Plus (+) symbol at the end of the line.Account Contacts(Required)TitleNamePhoneEmail Add RemoveAdd more contact rows by clicking the Plus (+) symbol at the end of the line.Marketing 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$870.00 GST$43.50 Total$913.50 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)We are interested in becoming an Official Annual SupplierSelect the Supplier levelVelocity ($35,000+)Turbo ($20,000+)Accelerated ($10,000+)Torque ($7,500+)
