1. No category

Allied Trades
2015/2016 OTA Membership Application Form
Company Name
Mailing Address
City
Prov/State
Main Phone
Postal
Main Fax
Toll Free
Billing Address (if different from mailing)
Company Email (for OTA Buyer's Guide)
Website URL
Number of Employees
DECLARATION: Please read carefully before completing form. By checking the appropriate box, you are giving OTA your consent to
use the information as stated:
The information collected in this application form will be published in our on-line Buyers’ Guide directory. If you wish your information to be
included in the directory, please indicate by checking the box.
From time to time, we make our membership list available to third-party companies to conduct industry surveys and questionnaires. If you
wish to be included in this list, please indicate by checking the box.
YOUR PRODUCTS & SERVICES (choose all that apply)
Help OTA serve you better by telling us about your company. This information will be included in the online listing of the OTA Buyers' Guide: www.ontruck.org
Choose the primary categories that generally defines the products/services you provide first then choose the sub-categories that clearly
describes the services you provide for these products.
Sub-Categories
Primary Categories
Cargo Securement (CSEC)
Primary Categories
N/A
Cleaning Equipment &
Supplies (CES)
N/A
Refrigeration-Heating-Cooling
(RHW)
Sales
Maintenance
Safety Equipment-Security
(SES)
Apparel
Service
Consulting Services (CSER)
Data Services (DSERV)
Electrical (ELEC)
Engines/Drivetrain (ENG)
Compliance
Finance
Tax
Legal
Communications
Internet
Software
N/A
Components
Scales (SCL)
Sub-Categories
N/A
Tires (TI)
Manufacturer
Maintenance-Repairs
Sales
Trailer-Tank (TT)
Accessories
Components
Leasing-Rentals
Maintenance-Repairs
Parts
Manufacturer
Sales
Graphics (GR)
Additives
Filtration
N/A
Human Resources (HR)
Recruitment
Training (TRA)
Insurance (INS)
Broker
Carrier
Materials
School
Truck (TR)
Accessories
Components
Leasing-Rentals
Maintenance-Repairs
Parts
Manufacturer
Sales
Fuel (FUEL)
Load Broker (LB)
Maintenance (MAINT)
Material Handling (MH)
Media (MED)
Paints-Finishes-Coatings (PFC)
Recycling-Recovery-Waste
Sytem (RRW)
N/A
Equipment
N/A
Printing Service
Publications
N/A
Equipment
Truck Stops (TSTOP)
N/A
Provide a brief description of your company's product and/or service offerings to the trucking industry
List All Branches/Dealers (These companies are encouraged to take out separate membership)
City
Prov/State
Phone
Email
Main Contact
Name
Direct Phone
Title
Mobile Phone
Signature
Email Address
Extension
Choose Your Category
Local: $650 (applies to you if your customers are within 160km. radius from your business address)
Provincial: $1,000 (applies to you if your customers are throughout the province of Ontario)
National: $1,750 (applies to you if your customers are throughout North America)
How to Calculate Your Dues
Step1: Select current month
Step 2: Select your Allied Trades Membership Category and your membership dues will be calculated automatically
A. Select current Month from drop-down list
B. This is your annual Membership Dues
=
0
D. Your Pro-Rated Membership Dues:
=
$0.00
=
$0.00
E. HST/GST (HST #10780 1003 RT 0001)
=
$0.00
F. Total Membership Dues including HST
=
$0.00
Logo Placement in Buyer's Guide & Printed Directory
Note about HST/GST:
HST/GST is calculated based on the
province your company is domiciled in.
For companies domiciled in a US state,
HST is 0.00.
Logo Placement- Please provide a Hi-Res EPS version only.
Method of Payment
Visa
Amex
MasterCard
Cheque Enclosed
Payment MUST accompany this application and are payable in Canadian
Funds. Call OTA's Membership Department at 416.249.7401 for assistance.
Card Number
Expiry
Cardholder
Cardholder Email
Cardholder Phone
Extension
Card Holder Signature
Return your application and payment in an envelope marked "Confidential" to:
Ontario Trucking Association | 555 Dixon Road, Toronto, Ontario M9W 1H8 | Phone: 416.249.7401 | Fax: 1.866.713.4188
For OTA Use Only
Cheque/Auth #
Amount Paid
Member ID
Process Date
Membership Period
Processed By
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