Membership Form
Business Name: *
Date Mobile Retail Business Started: *
PR or Marketing Agency (If applicable):
Contact Name: *
First *
Last *
Address: *
Street Address *
Address Line 2
City *
State / Province / Region *
Postal / Zip Code *
Country *
Email: *
Phone: *

Additional Contact Name:
Number of trucks owned:
Web Site:
Facebook Link:
Twitter Link:
Instagram Link:
Brief Description of Business (This bio will be used as your business listing on the AMRA website): *
Primary City Business Is Conducted In: *
Branch applying for: *
Are you a member of a Neighborhood Council or Chamber of Commerce?
Name of Neighborhood Council or Chamber of Commerce:
Referred by:
*if applicable

I have read, understood and agree to the AMRA Code of Ethics. *
Please refer to the Code of Ethics on the about page.
Indemnification by Members: *
Members agree to defend, indemnify, and hold harmless Association, its affiliates, officers, directors, employees, and agents from and against any and all third party claims, damages, liabilities, costs and expenses (including, without limitation, court costs and reasonable outside attorneys’ fees) whether a suit is instituted or not, and if instituted whether at trial or appellate level, arising out of or in connection with a claim of Members' infringement upon any third-party patent, trade secret, trademark, copyright or other proprietary right. This indemnity provision shall survive the termination of this Membership Agreement.
What are you hoping to gain from your membership? *
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