CCA Anuual General Meeting
April 26th, 2012 Toronto, ON

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OWNER / VOTING MEMBER INFORMATION

First Name :

Last Name :

Company Name :

Business Office Address :

City :

Province/State :

Postal Code :

Telephone :

Fax :

E-Mail :

The Canadian Carwash Association has added new features to its website for the betterment of its members. One feature is a members’ only forum to post technical questions, discuss issues and trade information with other members from across the country. NOTE: This form is for operator membership only; suppliers or associates should use the associate application online form.

ANNUAL DUES

Basic Membership (1st site) :

Additional Carwash Sites :

No. of sites @ $39.00 per wash :

Sub-Total :

Plus GST/HST (GST#124773920) :

Total Membership Fee :

1 Maximum membership fee of $8,025 (before tax), equivalent to 201 sites (initial site + 200 additional).

PAYMENT METHOD

If you wish to pay by cheque, please print this page and mail it with your cheque payable to the Canadian Carwash Association to:

Canadian Carwash Association
346 – 4195 Dundas Street West Toronto, Ontario M8X 1Y4

If you wish to pay by credit card, press the button below and you will be taken to a secure Moneris online website for payment:

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