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Application for ITA Membership as a Motor Carrier
*Note:
All fields marked with an asterisk (*) are required.
*
Company Name
Primary Contact
Primary Contact Title
*
Email Address
*
Full Mailing Address
Company Phone Number
Primary Contact Cell phone
Website
DOT number
Total Miles driven, in Idaho, in the previous year.
*
Idaho Mileage
Number of trucks in your fleet.
Power Units
Check the Conference that most closely fits your company
Highway Carrier
Resource Transporter
Specialized Transport
Safety Director Name
Safety Director Email
Safety Director Phone
Other Contact Name
Other contact Title
Other Contact Email Address
I hereby apply for membership in the Idaho Trucking Association. I agree to abide by the Association by-laws. Typing my name constitutes my electronic signature.
Agreement