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CLICK HERE FOR PRINTABLE APPLICATION TO FAX OR MAIL

THEN PRINT THEN CLICK BACK TO SCRDA - THANK YOU

Membership Application

New Applicant _____________ Renewing Member ___________

_____Direct Member $250 _____Associate Member $150

Company _________________________________________________________

Contact Name____________________________ Title _____________________

Mailing Address ____________________________________________________

Street Address______________________________________________________

City _____________________________ State __________ Zip ______________

Telephone ____________________________Toll free _____________________

Fax Number _______________________ Email __________________________

Website_________________________________

Signed______________________________________ Date_________________

Thank you for your interest in our organization. Start up dues must accompany this application. If you have any questions, please call Heather Smith at (803) 252-1087.

Please make check payable to SC Recyclers and Dismantlers Association or SCRDA and mail to:

SCRDA
Attn: Membership
PO Box 1763
Columbia , SC 29202

THE FOLLOWING QUESTIONS ARE FOR DIRECT MEMBER APPLICANTS ONLY. Your association acquires and compiles data from its members. It is not necessary for you to answer the questions, but the more information we are able to obtain, the more productive our association will be.

Business Type (s):

' Salvage ' Auto Sales ' Rebuilder ' Specialty ' Other_____________

Years in Business _________ Including all active officers and owners, number of full time employees? ________

Is your inventory computerized?

' Yes ' No Are you an Eden member? ' Yes ' No

Do you and/or your employees have access to medical coverage through your company?

' Yes ' No

Are you a subscriber to any other long distance services?

' Yes ' No If yes, which one?________________

Do some or all of your employees wear uniforms?

' Yes ' No If yes, cost per employee per week? ________

What is your workers compensation experience modification? ______________________


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