Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Contact Name *

First Name

Last Name

Phone

(###)

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Membership Sector - Please Choose ONE of the following: *

(Plus additional graduated fee if applicable - See Membership Fees page for example)

Service Contractor - $325 +HST

Manufacturer’s Agent - $400 +HST

Equipment Wholesaler - $750 +HST

Branded Distributor of Major Oil Company Member - $600 +HST

Non Industry Affiliate/ Associate - $400 +HST

Equipment Manufacturer - $1,000 +HST

Major Oil Company - $10, 500 +HST

Independent Petroleum Distributor Minimum Fee - $400 +HST ***Where the Distributor member has more than 4 tanker trucks, they shall pay an additional $100.00 for each tanker unit over 4, and an additional $65.00 for each truck tractor over the total, to a maximum fee of $3000.00.***