MEMBER APPLICATION FORM Become An OPTTA Member Today!Download & complete the PDF or complete the form below!Download PDF Here Company Name * Address * Address 1 Address 2 City State/Province Zip/Postal Code Country Phone Number * Contact Name * First Name Last Name Email Address * Referred By Membership Sector - Please Choose ONE of the following: * (Plus additional graduated fee if applicable - See Membership Fees page for example) Service Contractor $325.00 +HST Manufacturer’s Agent $400.00 +HST Equipment Wholesaler $750.00 +HST Non Industry Affiliate/ Associate $400 +HST Branded Distributor of Major Oil Company Member $600.00 +HST Equipment Manufacturer $1000.00 +HST Major Oil Company $10,500.00 +HST Independent Petroleum Distributor Minimum Fee of $400.00 +HST Graduated Fee Structure: Where the Distributor member has more than 4 trucks, they shall pay an additional $100.00 for each single or tandem axle tanker unit, and a fee of $65.00 for each truck tractor they own to a maximum fee rate of $3000.00. Example: ABC Fuels Ltd. owns 6 tandem fuel trucks and 2 tractors. Their membership fee would be: Distributor with up to 4 Trucks - $400.00 2 Extra Trucks x $100.00 - $200.00 2 Tractors x $65.00 - $130.00 Total Fee = $730.00 +HST Payment Method * Please send this form with online etransfer to: Email: jim.wood@optta.ca Ontario Petroleum Transporters & Technicians Association P.O. Box 37 Newburgh, ON K0K 2S0 Tel: 905-604-8884 The information contained in this application will remain in confidence by OPTTA and will be released only as an industry aggregate Thank you for your member application!We will be sure to review it and get back to you asap! Member Directory click to view Public Resources click to view Member Section click to view