NABC - Application

Thank You for your interest in the National Auto Body Council. To apply for membership, please fill out and submit the following information.

Please fill out this form and PRINT IT OUT to mail or fax to us:

First Name
Last Name
Title
Organization
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
FAX
Web Page
E-mail

Please read the information below and choose a membership level:

Membership Level Check One		Member- ship Investment (US$)
	Diamond Membership	$5000
	Platinum Membership	$2500
	Gold Membership	$1000
	Silver Membership	$500
	Bronze Membership	$250
	Individual Membership	$100
	Technician/student	$25

How Did You Hear About Us? (answer below)

_______________________________________________________

By submitting this form, you agree to the membership pledge of the NABC:
"I am part of an ethical, trustworthy, honorable business within the Collision Repair Industry...I take pride in my professionalism and my ability to serve my customer…I respect the law and the environment…I continue to study my profession and am a participant in my community… I am proud to work in my chosen industry"

Print off and mail or fax form below to:

NABC
191 Clarksville Road
Princeton Junction, NJ 08550
FAX: 609-799-7032

FORM OF PAYMENT

Check

MasterCard

Visa

Amex

Invoice Me

Name (as appears on card): ___________________________________________________

Card No.: _________________________________________

Expires: ____________

Signature: __________________________________________

Date: ______________

REFUND POLICY: Membership Dues are refundable to the customer within 30 days of purchase. If you are unsatisfied, and the time has expired, please contact our office immediately for available options.

Changing the image of our industry, one consumer at a time.