|
Membership Application Ready to Join NPFDA? If so, you may Print and fax /mail the application National Poultry & Food Distributors Association 3150 Highway 34 East Suite 209, PMB 187 Ph: 770-535-9901, Fax: 770-535-7385
NAME ______________________________________________________________________________
TITLE_______________________________________________________________________________
COMPANY__________________________________________________________________________
STREET ADDRESS __________________________________________________________________
MAILING ADDRESS _________________________________________________________________
CITY ____________________________________ STATE ________________ ZIP _______________
TELEPHONE NUMBER(S) ___________________ FAX NUMBER __________________________
E-MAIL ADDRESS_______________________INTERNET ADDRESS________________________
NUMBER OF YEARS IN BUSINESS______REFERRED BY________________________________
I/We ____________________________________________ hereby make application for membership in the National Poultry and Food Distributors Association , on this day of _________________, 20_____, and agree to abide by the Constitution and By-Laws of the Association and the rules adopted in conformity with same, and to pay dues promptly as they may be fixed by the Board of Directors and ratified by membership. In compliance with section 8.6 of Article VIII of the Association's By-Laws, I/We hereby designate __________________________________________ As my/our representative and ___________________________ As my/our alternate
Signature ___________________________________________________ Title _______________________
PLEASE CHECK ONE : * Annual Dues Active Membership: qIndependent Distributor $ 500.00 qProcessor/Distributor $ 500.00 qBroker/Trader/Marketer Specialist $ 500.00 qProcessor (Broiler) $ 500.00 qProcessor (Turkey) $ 500.00 qProcessor (Other) $ 500.00 qSupply Company $ 500.00 qTransportation Company $ 500.00 qMembers Branches (Parent Company Must be a Member) $ 100.00 ________CHECK ENCLOSED
________CHARGE CARD : MC,VISA,AMEX NUMBER__________________________EXP. DATE___________
* One year's dues are required with application. However, there is no penalty to joining at any time of the year for your dues are pro-rated for the next year. Under federal law, contributions or gifts to NPFDA are not tax deductible as charitable contributions. However they may be deductible as ordinary and necessary business expenses. Dues are deductible as ordinary and necessary to the extent that they are not used for lobbying expenses.
As a new member and by signing my name, I authorize NPFDA and the NPFDA Scholarship Foundation to send me correspondence vie emails and faxes. |
