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     Join Today With Our Online Application

 
 

  We will be happy to process your membership application with our online
  application. Just complete the below information and then submit.


 
  Your Name:   
  Your Company:  
  Address:  
  City:  
  State:  
  County:  
  Postal Code:  
       
  Telephone: 1234567890  (No dashes or spaces)
  Fax Number: 1234567890  (No dashes or spaces)
  E-Mail:  
  WebSite:  
     
     
  Primary Industry Segment:  
                           Independent Dealer Multiple Shop Education
     
                  I authorize the IABA to send me IABA Information by Fax and by E-Mail

 

  Single Shop Location $   395.00 *
    Note: All Locations Within the State Must be Members
 
 
    Multiple Shops: (Please send all location information and contacts by e-mail)  
  2 Facilities Within the State $   600.00 *
  3 Facilities Within the State $   750.00 *
  4+  Facilities within the State $ 1000.00 *
       
  Individual Education Membership $   150.00 *
  Out of State $   250.00 *

 

                            * Annual Dues Payments are for 12 months from the date of approval.
   

Payment Information


  I am sending a check payable to IABA today to: IABA  PO Box 532364  Indianapolis IN 46253
 
  I am paying by Credit Card Annually
  I am paying by Credit Card on an Auto Monthly Payment Option **

        ** Monthly Auto Payments are based on 10% of Annual Dues paid for each month.

   The annual dues for repair facilities includes the IABA ID Kit which includes the outdoor signage and
   window decal. ID Kits are not included with other memberships, but can be ordered. Two ID kits are
   provided to multi-shop members included in the dues. Additional kits can be ordered at a cost of
   $99.00. (One time fee)

   Please send me (additional) IABA ID Kits for my facility @ $99.00 each.

 
Select One:      
 
 
Payment Method  Master Card  VISA  
 American Express   Discover
 
Exp:  
Card Number:  
Name on Card:    
Billing Address: CVC Code  
Postal Code:  
  All information is required to process the credit card    
  A charge on your credit card statement will appear as IABA    

Acknowlegements

 

   
        I understand my credit card will be charged for the annual dues for this year only.

        I understand the usage of the IABA ID materials/Members Portal is contingent upon
            being an active current member, and if I am delinquent on dues, and/or no longer a
            member, I may be requested to remove the signage and ID materials, and return to
            the IABA upon request.

        I was referred to join by another IABA Member or Sponsor ?

            If so, by whom: 

    You must validate your are an actual person:
                                                                  Enter the sum of 15+2+13              

 

 


 

    

 

 

            If you are interested in becoming a sponsor contact us at: Director@iaba.info



 
Last Change: 04/14/2015