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Name*
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Company Name*
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Title*
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Company Address
(Mailing):
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Address
1*
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Address
2
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| City* |
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State/Province |
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| Zip/Postal
Code |
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Country*
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Company Address
(Physical):
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Address 1*
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Address
2
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| City* |
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State/Province |
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| Zip/Postal
Code |
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Country*
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| Telephone (xxx-xxx-xxxx)*
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Fax Number (xxx-xxx-xxxx) |
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Email Address |
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| Website |
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How did you hear about us?*
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Website
SCRA
Info Pack
Insurance
Other
Word of Mouth
(enter name/co below)
Name:
Company:
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Add'l Personnel/Title for Directory |
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Revenue Category*
See Revenue Categories |
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Type of Business*
Note:
You can only appear in one section of the
directory (Industry or
Allied).
Please choose
a category that best fits your company
For Industry Members (use Industry Service Codes only)
Select One Type (1, 2 or 3) AND
Select One or more Industry Service Codes
For Allied Members (use Allied Service Codes only)
Select One Type (3, 4 or 5) AND
Select One or more Allied Codes
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INDUSTRY MEMBERS:
(1) Industry-Transportation
(select Service Code)
(2) Industry-Crane & Rigging/Transp
(select
Service Code)
(3) Industry-Crane & Rigging
(select
Service Code)
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Industry Service Codes
Business type 1, 2 or 3
(check all that apply)
C (C&R Service)
I (International)
M (Millwrighting)
O (Oil Field Hauler)
S (Steel Carrier)
T (Transportation)
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ALLIED MEMBERS:
(4)
Allied-Transportation
(select
Allied Code)
(5)
Allied-Transportation/C&R
(select
Allied Code)
(6)
Allied-Crane & Rigging
(select
Allied Code)
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Allied Service Codes
Business type 4, 5 or 6
(check all that apply)
A Auction Services
B Brokers/Freight Forwarders
C Consultants-Associations
D Consultants-Engineers (Lic)
E Consultants-Engineering (Other)
F Consultants-Marine
G Consultants-Publications
H Consultants-Safety
I Consultants-Software
J Crane Manufacturers
K Escort
Services
L Financial/Tax
Services
M Insurance
Services
N Leasing,
Rental, Sales
O Legal
Services
P Lifting
Components/Services
Q Permit
Services
R Truck
Stop/Weigh Services
S Truck/Trailer
Mfgs
T Truck/Trailer
Components/Services
U
Manufacturer-Other
V
Consultants-Other
W
Rigging Products Supplier
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Special
Offer Dues for the First Year-If you join today-$395 (First time members only) |
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Total $ |
$395 (Intro rate valid thru 12/31/10)
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Payment Method*
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VISA
MC
AMX
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Name on Card*
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Account #*
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Expiration Date (mm/yy)*
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Submit
online or mail/fax to:
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Specialized Carriers & Rigging Association
2750 Prosperity Avenue, Suite 620
Fairfax, VA 22031-4312
Phone (703)698-0291
Fax (703) 698-0297
Email: info@scranet.org
URL: http://www.scranet.org
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