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Membership Application

ٱNew Applicant _____________

Renewing Member ___________

Direct Member $200

Associate Member $100

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 Gabrielle Barnes at (803)  252-1087. 

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

 

SCRDA

Attn: Membership

P.O. 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): ٱSalvage ___Auto Sales ٱ_____Rebuilder ٱ_______Specialty ٱ_________Other_____________

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

Is your inventory computerized? ٱ Yes ٱ No Are you an Eden member? ٱ Yes ٱ No

Do you and/or your employees have access to medical coverage through your company? ٱ Yes ٱ No

Are you a subscriber to any other long distance services? ٱ Yes ٱ No If yes, which one?________________

Do some or all of your employees wear uniforms? ٱ Yes ٱ No If yes, cost per employee per week? ________

What is your workers’ compensation experience modification? ______________________