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$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+)Torque ($7,500+)