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Allied Member Application
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Allied Membership Application
Arizona Trucking Association has represented and provided services for the trucking and distribution industry since 1937. To help us provide superior service to your company, please be sure to completely fill in all the blanks. If a question doesn’t apply to your company, simply write “N/A”. Thank you!
COMPANY INFORMATION
Where does your company conduct business?
(Required)
Please Choose One
Arizona Only ($681.25 Annual Dues)
Regionally / Nationally ($888.50 Annual Dues)
What service does your company provide?
(Required)
Please choose one
Attorney
Compliance Assistance/Consultant
Diesel Engines
Driver Training/Leasing/Placement
Equipment Dealer
Equipment Renting & Leasing
Financial Services
Fuel Supplier
Insurance Provider
Intelligent Transportation Systems/Software
Parts & Accessories
Refrigeration Services
Repairs/Maintenance/Body Shop
Tires/Wheels and Accessories
Towing & Recovery
Trailer / Truck Dealer
Other
If other, please list below
Company Name:
(Required)
Mailing Address
(Required)
Street Address
City
State / Province / Region
ZIP / Postal Code
Website
(Required)
Main Phone
(Required)
Owner / CEO Name
(Required)
First
Last
Email
(Required)
Title
(Required)
Office Phone
Cell Phone*
(Required)
*By providing a cell phone number, you are opting in to receive text message updates from the Arizona Trucking Association (ATA). Phone numbers will never be shared, sold, or used for any purpose other than official ATA communications.
Total Years in Business:
(Required)
Please enter a number from
0
to
500
.
Years Conducting Business in Arizona:
(Required)
Please enter a number from
0
to
500
.
Please provide a short blurb describing your company. This will be used in our new member announcement.
Please upload your company logo (jpg, png or pdf preferred)
Max. file size: 32 MB.
PUBLISHED CONTACT
This is the designated public point of contact. The name and phone number listed here will be included on contact lists shared with other Arizona Trucking Association (ATA) members upon request.
Is the published contact the same person as the Owner/CEO list above?
(Required)
Yes
No
Published Contact Name
First
Last
Published Contact Title
Published Contact Email
Published Contact Phone
Published Contact Cell Phone*
*By providing a cell phone number, you are opting in to receive text message updates from the Arizona Trucking Association (ATA). Phone numbers will never be shared, sold, or used for any purpose other than official ATA communications.
Is Published Contact address the same as Company Address listed above?
(Required)
Yes
No
Published Contact Address
Street Address
City
State / Province / Region
ZIP / Postal Code
Which address should the new member packet be mailed?
(Required)
Mailing Address
Published Contact Address
Other
BILLING CONTACT (If different from Owner/CEO)
Billing Contact Name
First
Last
Billing Contact Title
Billing Contact Phone
Billing Contact Email
Billing Contact Cell Phone*
*By providing a cell phone number, you are opting in to receive text message updates from the Arizona Trucking Association (ATA). Phone numbers will never be shared, sold, or used for any purpose other than official ATA communications.
HUMAN RESOURCES CONTACT (If different from Owner/CEO)
Human Resources Name
First
Last
Human Resources Contact Title
Human Resources Contact Phone
Human Resources Contact Email
Human Resoures Contact Cell Phone*
*By providing a cell phone number, you are opting in to receive text message updates from the Arizona Trucking Association (ATA). Phone numbers will never be shared, sold, or used for any purpose other than official ATA communications.
MARKETING CONTACT
Marketing Name (If different from Owner/CEO)
First
Last
Marketing Contact Title
Marketing Contact Phone
Marketing Contact Email
Marketing Contact Cell Phone*
*By providing a cell phone number, you are opting in to receive text message updates from the Arizona Trucking Association (ATA). Phone numbers will never be shared, sold, or used for any purpose other than official ATA communications.
PERSON RESPONSIBLE FOR VEHICLE LICENSING (If different from Owner/CEO)
Vehicle Licensing Contact Name
First
Last
Vehicle Licensing Contact Title
Vehicle Licensing Contact Phone
Vehicle Licensing Contact Email
Vehicle Licensing Contact Cell Phone*
*By providing a cell phone number, you are opting in to receive text message updates from the Arizona Trucking Association (ATA). Phone numbers will never be shared, sold, or used for any purpose other than official ATA communications.
SAFETY CONTACT (If different from Owner/CEO)
Safety Contact Name
First
Last
Safety Contact Title
Safety Contact Phone
Safety Contact Email
Safety Contact Cell Phone*
*By providing a cell phone number, you are opting in to receive text message updates from the Arizona Trucking Association (ATA). Phone numbers will never be shared, sold, or used for any purpose other than official ATA communications.
OTHER CONTACTS
ADDITIONAL EMPLOYEES FOR OUR DATABASE TO RECEIVE E-BULLETINS AND OTHER INDUSTRY INFORMATION.
Other Contact 1
First
Last
Other Contact 1 Email
Other Contact Cell Phone*
*By providing a cell phone number, you are opting in to receive text message updates from the Arizona Trucking Association (ATA). Phone numbers will never be shared, sold, or used for any purpose other than official ATA communications.
Other Contact 2
First
Last
Other Contact 2 Email
Other Contact2 Cell Phone*
*By providing a cell phone number, you are opting in to receive text message updates from the Arizona Trucking Association (ATA). Phone numbers will never be shared, sold, or used for any purpose other than official ATA communications.
If you prefer to provide an excel spreadsheet for your company contacts, please upload below or email to membership@aztrucking.com
Max. file size: 32 MB.
ATA provides many opportunities to our allied members for marketing and networking.
Please check any you would like to learn more about.
ATA provides many opportunities to our allied members for marketing and networking. Please check any you would like to learn more about.
Complete Membership Database (Upon request)
Advertise in Arizona Trucking Association Yearbook
Annual Carrier Conference Sponsorship/Attendance
Networking Events
Distribution of Marketing Materials in our Vehicle Registration Department
ATA provides many opportunities to our allied members for marketing and networking. Please check any you would like to learn more about.
Event Sponsorship: Truck Driving Championships/Other Events
Safety & Maintenance Council
Seminars/ Training
Arizona Trucking Association Foundation (ATAF) Scholarship Program
Volunteer Opportunities
How did you hear about ATA?
From another member
Website
Attended an ATA seminar or Event
If we have questions about the application who do we contact?
Name
(Required)
First
Last
Email
(Required)
Phone
(Required)
Once we review and approve your application, we will send you an invoice.
Preferred Method
(Required)
Check
ACH
Credit Card
Total
CAPTCHA
Thank you for your application, dues payment and supporting documents. Once your application has been approved, you will receive a complete membership packet. For information in the meantime, contact us at 602-850-6000.
