Application for Membership

Initiation fee: $5.00, Annual dues: $35.00, Total: $40.00

For an additional $10.00 you can buy a link to the world on our world wide web page.

For an additional $10.00 you can buy a one year subscription to our digest calling card page.

First Name:
Last Name:
Your Company's Name:
Title:
Bus. Phone Number:
Fax Number:

Email Address:
YOUR BUSINESS		YOUR RESIDENCE

	Address
	City
	State
	Zip
	Res. Phone Number

Air	Motor	Shipper	Rail	Water	Other

Total Due:	$40.00	$50.00	$60.00

$10.00

I am a current member and would like a web site link. Please enclose link information- email address, web site address and and brief explanation what services you company provides.

I hereby enclose membership dues in the amount of $_________for membership in the Raritan Traffic Club covering period expiring October 2009. I understand the my application is subject to the approval of the Board of Governors at the first meeting after application has been submitted. Upon election to membership I shall make myself subject to the Constitution and By-Laws of the Raritan Traffic Club, and shall be enrolled and considered as a member until further notice of change or withdrawal. I further agree to pay annually, in advance, membership dues.

Proposed by: ____________________________________________

Endorsed by: ____________________________________________

Approved by: ____________________________________________

Date: __________________________________________________

Executive Secretary: ______________________________________

Please Print an additional copy for your records.