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NMIADA Scholarship Program

Member Application

Welcome and thank you for your interest in the New Mexico Independent Automotive Dealers Association (NMIADA), serving New Mexico dealers and the automotive industry since 1962. By completing this form, I am giving NMIADA, its affiliates and subsidiaries, my permission to (until I give written notice to discontinue) contact me and provide information to me at the mailing and e-mail address, telephone and fax numbers I have provided. All applications are subject to approval by the NMIADA Board of Directors to include renewals. Please note that 20% of your member fee is not deductible for income tax purposes since it is utilized for political action.

Step 1: Member Info

Step 2: Additional Info

Step 3: Primary Contact

Step 4: Billing Contact

Step 5: Membership Options

Step 1:

Member Info

Company Name *

Please add your company name.

Leave Blank

Phone *

Please add your company phone number.

Website

Email *

Please add a valid email.

Physical Address

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

State *

Please add your State.

State *

Please add your State.

Zip Code *

Please add your Zip Code.

Mailing Address

Same as physical address

Address line 1

Address line 2

Country

City

State

State *

Please add your State.

State

Zip Code

Step 2:

Additional Info

Directory Category *

Please select a directory category.

Full-time Employees

Part-time Employees

Dealer Number *

Looks good!

Preferred Language *

Looks good!

Business Model *

Looks good!

State Senator

State District

State Legislator

State District

Step 3:

Primary Contact

First Name *

Please add your first name.

Last Name *

Please add your last name.

Title *

Please add your title.

Phone *

Please add your phone number.

Cell Phone *

Please add your cell phone number.

Fax

Email *

Please add a valid email.

Contact Preference

Email

Phone

Address

Same as Address in Step 1

Address line 1 *

Please add your address.

Address line 2

Country *

Please add your country.

City *

Please add your City.

State *

Please add your State.

State *

Please add your State.

State *

Please add your State.

Zip Code *

Please add your Zip Code.

Step 4:

Billing Contact

Same as Primary Contact

First Name

Last Name

Title

Phone

Cell Phone

Fax

Email

Contact Preference

Email

Phone

Address

Same as Primary Contact Address

Address line 1

Address line 2

Country

City

State

State *

Please add your State.

State

Zip Code

Step 5:

Membership Package

Please select a Membership Package

Dealer Member Dues - 1yr $ 99

Political Action

Legal Defense Fund

Scholarship Donation

Associate Member - 1 yr $ 500

Bronze - Sponsor Member - 1yr $ 1,500

Silver - Sponsor Member - 1yr $ 2,500

Gold - Sponsor Member - 1yr $ 5,000

Platinum - Sponsor Member - 1yr $ 10,000

Comments/Questions

Payment Option

Charge my credit or debit card

Please complete the Captcha

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© 2021 New Mexico Independent Automobile Dealers Association NMIADA | Site by GrowthZone

New Mexico Independent Automobile Dealers Association

(505) 232-0809

604 Chama St NE | Albuquerque, NM 87108

info@nmiada.com

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© New Mexico Independent Automobile Dealers Association NMIADA. All Rights Reserved | Site by GrowthZone

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