Membership Application

    Application for Membership

    The Machinery Haulers Association, Inc.
    P.O. Box 338, Dysart, Iowa 52224
    Phone: 319-214-7323
    tmha@machineryhaulers.org    www.machineryhaulers.org

    Applying for Membership as a:

    Name of Applicant Company:

    Mailing Address:

    Street Address:

    City:

    State:

    Zip Code:

    Business Phone:

    Fax:

    Toll-free Number (Optional):


    Primary Type of Service Provided:

    Number of OTR Power Units Operated (if a Motor Carrier):

    If a Motor Carrier, what % of your business is from asset-based operations?


    Primary Company Representative:

    Title:

    His/Her Cell:

    E-mail Address:


    Secondary Company Representative:

    Title:

    His/Her Cell:

    E-mail Address:

    Company President’s Name:

    E-mail Address:

    Any Additional Information You Wish to Provide: