Services & Solutions for Successful Equipment & Hardware Retailers!

Equipment Membership Application

Please complete this form to join the SouthWestern Association. After the form has been completed and you click on the "send" button, this form will be transmitted to SouthWestern.

• Application for Membership:

  Company Name
  Address
  PO Box
  County
  City
  State
  Zip
  Phone
  FAX
  Web address

• Major line or franchise:

• Additional lines carried:

• Do you carry outdoor power equipment?
  Yes
  No

  Major lines

• Do you sell (check all that apply):
  Cars or Trucks
  ATV's or Motorcycles
  Boats
  RV's
  Snowmobiles

• Please describe sales mix:
  Agricultural Equipment - %
  Construction Equipment - %
  Consumer Products - %
  Other (Describe: ) - %

• Number of employees:

  # of Full Time Employees
  # of Part Time Employees

• Branch location(s).   For each branch, list address, city, county, state and store manager:

  Address	City	County	State	Store Manager

• Business Organization
  Choose one of the following options:

  	Corporation
  	Partnership
  	Proprietorship
  	Other

• :

  	Name	E-Mail Address
  Owner
  Owner
  Manager
  Office Manager
  Credit Manager
  Parts Manager
  Service Manager
  Business Forms
  Education/Training/Safety
  Human Resources
  Insurance

• Contact Person (if not owner)

  Name

  Title

• Recommended by:

  Name

• Membership Investment Schedule:

  	Farm Equipment Dealer (1 Location)	$500.00
  	Industrial Equipment Dealer (1 Location)	$500.00
  	Outdoor Power Equipment Dealer (1 Location)	$350.00
  	Equipment Associate (Not a Dealer)	$600.00
  	Multi-Location Equipment Dealer -Main Store	$500.00
  	Multi-Location Equipment Dealer - Each Branch	$175.00

• SouthWestern Association Member Services
  Please send me more information about the following industry-specific services available only to SouthWestern Association Members:

  Accounting Systems & Procedures	Legal Services
  Advertising Specialty Items	Management Incentive Programs
  ATS-GPS Theft Control on Equipment	Marketing/Advertising
  Bankcard Acceptance Program	Mergers/Acquisitions
  Business Forms	On-site Programs
  Business Valuations & Operations Assessment	Exit & Expansion Strategies
  Computer & Technology Analysis & Integration	Financial Training and Education
  Convention/Annual Meeting	Aftermarket Development
  Credit/Lien Manuals [State:	Leadership & Management Training
  Credit Reporting Services	Customer Service Training
  Dealer to Dealer Programs	Professional Selling Skills
  Drug & Alcohol Testing Programs	Succession/Operational Cross Training
  EDCO Inventory & Retail Financing	Regulatory Compliance
  Employee & Management Benefit Program	Retirement/401(k), Profit Sharing
  Employee Policy & Procedure Manuals	Seminars
  Estate Planning	Trade-In Guides
  Group Health, Life & Business Insurance	Web Site Development
  IRON Solutions Products & Services	Other

• Insurance Coverage - SouthWestern Association offers significant savings to members on a number of insurance products.  Please complete the information below to help us serve you:
  Please list current Insurance provider and next renewal date:

Coverage	Current Provider	Next Renewal Date
Group Health (must have 2 or more eligible)
Worker's Compensation
General Liability
Property & Casualty
Dental
401(k) and Profit Sharing
Other:

• Computer Systems

Hardware
	Computer brand, make, model, i.e. Toshiba Tecra 8000
Software
	For example: MS Office 2000, Quick Books 2000 etc.

• About Your Dues:
  Your annual investment includes membership in the North American Equipment Dealers Association and subscriptions to SouthWestern Retailer, the SouthWestern Association’s official publication, at the rate of $12 per year, and to Equipment Dealer, NAEDA’s Official publication, at the rate of $15 per year for dealers and $20 per year for associate members.

  This is an annual dues statement and not a request for a contribution or gift.  Payment of your dues makes you a member of the SouthWestern Association and SWA Trade Association.  Your dues payment is allocated to these two organizations.

  Contributions or gifts to SouthWestern Association are not tax deductible as charitable contributions for income tax purposes.  However, they may be tax deductible as ordinary and necessary business expenses subject to restrictions imposed as a result of association lobbying activities.   SouthWestern Association estimates that the nondeductible portion of your dues allocable to lobbying is 8%. 
   

• Enter the total amount below and then select the payment method.  If you are sending a check then print this form before you click on the "Send to SouthWestern" button below.  If you are paying by Charge Card then select that form of payment and then click on the "Send to SouthWestern" button - Charge Card information will be requested.  In either case, your registration information will be forwarded to the SouthWestern Association when you hit the "Send to SouthWestern" button.

  Total Amount
  Payment	Check will be mailed Charge Card Payment