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Application for International Associate Membership

ELIGIBLITY REQUIREMENTS: An individual, proprietorship, partnership or corporation which supplies equipment, products or services to the automotive industry. Any other organzition may be approved for associate membership by the board of directors.

Company Information

* Indicates required field

Company Name *

Date Business Started *

Contact Person *

First

Last

Phone Number *

Business Address *

Line 1

Line 2

City

State

Zip Code

Country

Fax Number *

Website *

Email *

Federal ID Number *

Products and/or services offered to wholesalers *

Other trade associations you are affiliated with *

SERVICE GROUP (check all boxes that apply) *

BP - Business Press CP - Computer Services SC - Core Supplier ED - Engine or Engine Component Distributor M - Importer MP - Manual Publisher RM - Remanufacturer SS - Shop Supplies VT - Vocational Training WD - Warehouse Distributor Other

MANUFACTURER'S GROUP (check all boxes that apply) *

CM - Chemical Adhesive Mfr EM - Equipment Mfr or Supplier MR - Manufacturer's Rep or Agent PM - Parts Mfr or Supplier

Membership dues *

Manufacturer's Rep, Agent or Business Press - $439 $0-$1,000,000 in automotive sales - $639 $1,000,000-$3,000,000 in automotive sales - $739 Over $3,000,000 in automotive sales - $839

Payment type *

I will pay online. I will mail a check. I would like a monthly payment plan.

Where did you learn about AERA? *

PROSIS PRO demo Social media Conference Another member Engine Professional magazine Web search Other

Submit

QUICK LINKS
Engine Professional Magazine
PROSIS PRO Engine Specification Software
AERA Automotive Machining Online Training
EREF Engine Rebuilders Educational Foundation
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AERA Engine Builders Association
875 Feinberg Court, Suite 106
Cary, IL 60013 USA
toll-free 888.326.2372 or 815.526.7600
Fax 888.329.2372 or 815.526.7601
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