Member Application

KEEPING YOUR VOICE HEARD, YOUR DRIVERS SAFE AND BUSINESS ROLLING Helping pass state legislation that keeps your business ahead. Providing services that keep trucking running safer and more efficiently. Creating a community devoted to industry safety and an image of professionalism and service. For 80 years, the Alabama Trucking Association has been there for trucking wherever the rubber meets the road, and we’re still finding ways to keep progress on schedule.

Business Information

Company Name: *

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Phone: *

Website:

Email: *

Business Description (200 char max):

Employees:

Full-time Part-time

Business Keywords (enter a space between words):

DOT #:

Trucks/Tractors:

Physical Address

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Line 2:

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State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

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State: *

Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Address

Same as Member Address

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Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Password: *

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

New Membership: See fee schedule to determine the fee and enter it below.
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Payment Option:

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