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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

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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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