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Member Application
Thank you for your interest in joining Midwest Auto Care Alliance. Please complete the application below and indicate your membership type. If you have any questions, please contact our office at (816) 413-9800.
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
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State
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Postal Code
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Please add your Postal Code.
Mailing Address
Same as physical address
Address line 1
Address line 2
Country
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Afghanistan
Albania
Algeria
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Belgium
Belize
Bermuda
Bolivarian Republic of Venezuela
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei Darussalam
Bulgaria
Cambodia
Cameroon
Canada
Caribbean
Chile
China
Colombia
Congo [DRC]
Costa Rica
Croatia
Czech Republic
Denmark
Dominican Republic
Ecuador
Egypt
El Salvador
Eritrea
Estonia
Ethiopia
Faroe Islands
Finland
France
Georgia
Germany
Greece
Greenland
Guatemala
Haiti
Honduras
Hong Kong
Hong Kong SAR
Hungary
Iceland
India
Indonesia
Ireland
Israel
Italy
Ivory Coast
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Korea
Kuwait
Kyrgyzstan
Lao PDR
Latin America
Latvia
Liechtenstein
Lithuania
Luxembourg
Macao SAR
Macedonia (Former Yugoslav Republic of Macedonia)
Malaysia
Maldives
Mali
Malta
Mexico
Moldova
Mongolia
Montenegro
Morocco
Myanmar
Nepal
Netherlands
New Zealand
Nicaragua
Nigeria
Norway
Oman
Pakistan
Panama
Paraguay
Peru
Philippines
Poland
Portugal
Principality of Monaco
Puerto Rico
Réunion
Romania
Russia
Rwanda
Saudi Arabia
Senegal
Serbia
Serbia and Montenegro (Former)
Singapore
Slovakia
Slovenia
Somalia
South Africa
South Sudan
Spain
Sri Lanka
Sweden
Switzerland
Taiwan
Tajikistan
Thailand
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
U.A.E.
Ukraine
United Kingdom
United States
Uruguay
Uzbekistan
Vietnam
Yemen
City
State
Choose...
Alabama
Alaska
American Samoa
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Federated States of Micronesia
Florida
Georgia
Guam
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Marshall Islands
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Northern Mariana Islands
Ohio
Oklahoma
Oregon
Palau
Pennsylvania
Puerto Rico
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virgin Islands
Virginia
Washington
West Virginia
Wisconsin
Wyoming
State
*
Choose...
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Northwest Territories
Nova Scotia
Nunavut
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon
Please add your State.
State
Postal Code
Step 2:
Additional Info
Directory Category
Choose...
Collision
Mechanical
Mechanical & Collision
Full-time Employees
Part-time Employees
Owners Name
*
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Spouse Name
Does your spouse work in the business?
*
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Yes
No
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If yes please include your spouse email
Contact's Date of Birth
Contact Cell Phone
Do we have permission to text you MWACA information?
*
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Yes
No
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Do we have permission to fax you MWACA information?
*
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Yes
No
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Date You Started in Business
Annual Gross Sales
Choose...
Under $100,000
$100,000 - $250,000
$250,000 - $500,000
$500,000 - $750,000
$750,000 - $1,000,000
More than $1,000,000
Division
*
Choose...
Mechanical/Transmission
Collision
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Primary Chapter
*
Choose...
Cedar Rapids, IA
Central MO
Des Moines, IA
Fort Smith, AR
Kansas City
Lawrence/Topeka
Lincoln, NE
Little Rock, AR
Oklahoma City, OK
Omaha, NE
Quad Cities, IA
Northwest Arkansas
Southeast Iowa
Springfield/Branson/Joplin
St. Louis, MO
Tulsa, OK
Wichita, KS
Virtual Member
Virtual Interest Group
Out of State
Regional
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Do you have multiple locations?
*
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Yes
No
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If yes, how many?
Do you have a valid business license?
*
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Yes
No
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Do you have liability insurance?
*
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Yes
No
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Do you have a commercial location?
*
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Yes
No
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Do you have a sales tax license?
*
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Yes
No
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Reference: Please list industry reference (Name, Title, Company, Phone)
*
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Reference: Please list industry reference (Name, Title, Company, Phone)
*
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How did you hear about MWACA?
*
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Step 3:
Primary Contact
First Name
*
Please add your first name.
Last Name
*
Please add your last name.
Title
*
Please add your title.
Cell Phone
Fax
Email
*
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Create Account
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Password
Step 4:
Billing Contact
Same as Primary Contact
First Name
Last Name
Title
Cell Phone
Fax
Email
Create Account
This Login is already in use
Login
Password
Step 5:
Membership Package
Please select a Membership Package
Midwest Auto Care Alliance Shop Membership
$
275
Independently owned service or collision repair facility
Midwest Auto Care Alliance Shop Member - Virtual
$
275
Independently owner service or collision repair facility outside of Missouri, Kansas, Iowa, Nebraska, Oklahoma and Arkansas. * Virtual members do not have voting rights
Midwest Auto Care Alliance Allied Membership
$
350
Available to companies providing products, services and benefits to the automotive service industry * Fees are per year. * Allied members do not have voting rights
MWACA Educational Membership
Available to educators of an accredited automotive program. * Educational members do not have voting rights
MWACA Student Membership
Available to a current full-time student enrolled in an accredited automotive program. * Student members do not have voting rights
Additional Options:
16" x 28" Aluminum Sign
$25 one time
Save $15 by ordering now! Reg $40 each
Additional Location #1
$100 one time
Please include the address of the additional location in the comment box below. $100 for first year (includes member sign) $75 per year after that
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