Arkansas Independent Automobile Dealers Association

Knowledge-Support-Success

APPLICATION FOR MEMBERSHIP

 Type of Membership:  Regular ______          Associate ______(non-dealers)

Company Name:  _________________________________________________________________

Owner’s Name:      ________________________________________________________________         

Mailing Address:   ________________________________________________________________

City/ State/ Zip:       ________________________________________________________________

Phone Number:     _____________________________      Fax: _____________________________

E-mail Address:     _________________________________________________________________

Web Address:        _________________________________________________________________

Kind of Business: (check all that apply) Independent ___  Franchise___ Retail____ Buy Here Pay Here____

Wholesale____ Auction House____     Body Shop____ Re-builder____  Salvage Yard____  Classic Cars_____     

Annual Dues $200.00

Make checks payable to: AIADA 

P.O. Box 147 - Magnolia, AR  71754

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