New Membership Form

* Required information

Member Information

* First Name:
* Last Name:
* Email Address:
* Confirm Email Address:
* Address 1:
* City:
Address 2:
* State:
* ZIP Code:
* Country:
* Phone:

Fee

Type	Fee
(1) Transportation Development Dues - Up to $1 million	$225.00
(1) Transportation Development Dues - $1,000,001 - $3 million	$375.00
(1) Transportation Development Dues - $3,000,001 - $6 million	$750.00
(1) Transportation Development Dues - $6,000,001 - $10 million	$1,125.00
(1) Transportation Development Dues - $10,000,001 - $20 million	$1,500.00
(1) Transportation Development Dues - Over $20 million	$2,500.00
(2) Consultant, Engineer, Architect Dues - Up to $200,000	$300.00
(2) Consultant, Engineer, Architect Dues - $200, 0001 - $500,000	$500.00
(2) Consultant, Engineer, Architect Dues - Over $500,001	$800.00
(3) Transportation Carrier Dues - 0-25 Power units	$150.00
(3) Transportation Carrier Dues - 26-50 Power units	$300.00
(3) Transportation Carrier Dues - 51-100 Power units	$450.00
(3) Transportation Carrier Dues - More than 100 Power units	$600.00
(4) Insurance, Bonding and Bank - Under $1 million	$300.00
(4) Insurance, Bonding and Bank -$1,000,001 - $5 million	$450.00
(4) Insurance, Bonding and Bank - $5,000,001 - $10 million	$750.00
(4) Insurance, Bonding and Bank - Over $10 million	$1,250.00
(5) General Business - Under $1 million	$225.00
(5) General Business - Over $1 million	$350.00
(6) Transportation Equipment Dealers - Up to $2 million	$350.00
(6) Transportation Equipment Dealers - $2,000,001 - $9 million	$750.00
(6) Transportation Equipment Dealers - Over $9 million	$1,250.00
(7) Municipalities	$75.00
(8) Associations	$50.00
(9) Library	No Charge
(10) Individual	$30.00
(11) Student	$10.00
(12) Educational Institution	$100.00

Organization Information

* Company:
Fax:
Website:
Number of Employees:
Brief description of organization (for MBTA Membership Directory -25 words or less):

Additional Information

Additional Contact Names and Titles:
characters remaining
Additional Email addresses:
characters remaining
Other Locations:
characters remaining
MBTA Recruiting Member:
Would you be willing to contact your local legislator about important transportation issues?
- Yes
- No

Payment

Payment Method

Pay with PayPal or Credit Card
Pay By Check
Please make check payable to:
Maine Better Transportation Association
150 Capitol Street, Suite 5
Augusta, ME 04330

Contact

New Membership Form - MBTA

Member Information

Fee

Organization Information

Additional Information

Would you be willing to contact your local legislator about important transportation issues?

Payment

Payment Method

Payment Summary