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Dealer Member Application

1 Store Annual Dues: $900
2 Store Annual Dues: $1,500
3+ Store Annual Dues: $2,000

Company name*

Physical Address*

Mailing Address (if different)

Company Phone*

Company Website

Owner of Company and Title*

Company Representative to attend meetings *

Representative Phone*

Representative Email*

Recommended VADA Member & Company

When was the business established?*

Number of Employees*

Do you have more than one store?*

Yes

No

If yes, please list store name, address, contact and phone.

Please list three (3) company references. Include company name, address, phone and contact.

Dues

Associate Member Dues
Price$900.00
Dues

Dealer Member Dues
Price$900.00
Dues

Dealer Member Dues- 2 Stores
Price$1,500.00
Dues

Dealer Member Dues- 3+ Stores
Price$2,000.00

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