International Technology Rental Association Membership Form

Please Use This Form to Request Membership in the International Technology Rental Association. In order for you to be considered for membership, you must be: 1) Sponsored by TWO of our current members 2) Technology rental company in business for more than two years 3) Filled out this form completely 4) Mailed your application fee to our current treasurer Make Check payable to: International Technology Rental Association Amount: $500 Mail to: Tom Hornyak ITRA Treasurer Micro Rental Service 4390 Rt. 8 Allison Park, PA 15101 Submission of online/printed form and dues does not mean automatic membership. Membership is contingent upon ITRA approval (typically a 60 day process) and receipt of your $500 annual dues (See Dues Information Below)
Company Name:
Street Address:
Street Address 2:
City:
State:
Zip:
Country:

Owner:
Phone/Ext:
Rental Contact Person:
Title Of Contact:
Phone/Ext of Contact:
Alternate Phone:
Fax:
Email:
Pager:
Website:

ITRA Sponsor(s):
Number of Years in Business:
Number Of Employees:
Coverage Area (Major Cities & States/Territory/Area):
Specialization(s):
D & B Number:

Short Description Of Your Business And Why You Want To Become A Member:
DUES INFORMATION: Dues for ITRA Membership is $500 and up annually First year's dues must be received before ITRA Membership will be considered Dues are by corporation Dues are deductible as a charitable contribution Dues are annual and payable 30 days from the date of invoice Make check payable to: International Technology Rental Association Amount: $500 Mail to: *Tom Hornyak* ITRA Treasurer Micro Rental Service 4390 Rt 8 Allison Park, PA 15101 [If membership is denied all dues will be returned]