Associate Membership Application Form 2020

Associate Membership Application

To apply for membership please complete all questions. We will invoice you after your application has been processed.

Please note if you were an Associate Member in 2019 you do not need to fill out this form unless contact/billing information has changed.

Contact Person Title

Company

Contact Person

First Name Last Name

Contact Person E-mail

Contact Address

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Billing Address (if different from above)

Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Billing E-mail

Work Number

Area Code Phone Number

Cell Number

Area Code Phone Number

Website

Type of business, products, or services provided:

Please upload a high resolution image of your company's log.

Browse Files

Associate Member Acknowledgement

I/We hearby apply for associate membership with the intention of supporting the WSTA mission to promote legislation benficial to public transit, promote and enhance the professional development of transit management, and promote public awareness, trust, and support of public transit.

By sending this application you acknowledge that you have read and agree with the above statement.

Signature *

Signature date *

Membership Level *

Business Partner $ 400.00

Non-profit/Government Partner $ 200.00

Individuals $ 50.00

Transit Agency Associate Member with operating budgets over $40 million $ 5,000.00

Transit Agency Associate Member with operating budgets between $15 million to $39.99 million $ 2,500.00

Transit Agency Associate Member with operating budgets between $2 million to $14.99 million $ 1,250.00

If you are filling this form out on behalf of the contact person, please leave your contact information below. Thank you!

Name

First Name Last Name

Job Title

Email

example@example.com