Membership Application

Join Us!

• The Annual Non-Prime Auto Financing Conference
• Annual Non-Prime Automotive Financing Survey, providing the industry's only measurements of growth and changes
• The Consumer Credit Compliance Certification Program
• Compliance Certificate Courses for front line staff
• Quarterly Compliance Roundtable for Certified Compliance Professionals
• Creation and publication of standards of financial reporting
• Development of a code of responsibility for the industry
• Regional workshops

Notice: If you prefer to mail your application, please print the form, and mail it with your payment to the address on the form. Company Name: * First Name: * Last Name: * Title: * Address: * Address(2): City: * State: * AL AK AR AZ CA CO CT DC DE FL GA HI IA ID IL IN KS KY LA MA MD ME MI MN MO MS MT NC ND NE NH NJ NM NV NY OH OK OR PA RI SC SD TN TX UT VA VT WA WV WI WY Province AB BC MB NB NL NT NS NU ON PE QC SK YT ------- Mexico Other ZIP: * Country * United States Canada Mexico Andorra United Arab Emirates Afghanistan Antigua/Barbuda Anguilla Albania Armenia Netherlands Antilles Angola Antarctica Argentina American Samoa Austria Australia Aruba Azerbaijan Bosnia Barbados Bangladesh Belgium Burkina Faso Bulgaria Bahrain Burundi Benin Bermuda Brunei Darussalam Bolivia Brazil Bahamas Bhutan Burma Bouvet Island Botswana Belarus Belize Cocos Islands Central Africa Congo Switzerland Cote D'Ivoire Cook Islands Chile Cameroon China Colombia Costa Rica Cuba Cape Verde Christmas Island Cyprus Czech Germany Djibouti Denmark Dominica Dominican Republic Algeria Ecuador Estonia Egypt Western Sahara Eritrea Spain Ethiopia Finland Fiji Falkland Islands Micronesia Faeroe Islands France Gabon United Kingdom Grenada Georgia Guiana Ghana Gibraltar Greenland Gambia Guinea Guadeloupe Equatorial Guinea Greece South Georgia Guatemala Guam Guinea-Bissau Guyana Hong Kong Heard And Mcdonald Islands Honduras Croatia Haiti Hungary Indonesia Ireland Israel India British Indian Ocean Territory Iraq Iran Iceland Italy Jamaica Jordan Japan Kenya Kyrgyzstan Cambodia Kiribati Comoros St. Kitts & Nevis North Korea Korea Kuwait Cayman Islands Kazakhstan Laos Lebanon Saint Lucia Liechtenstein Sri Lanka Liberia Lesotho Lithuania Luxembourg Latvia Libya Morocco Monaco Moldova Madagascar Marshall Islands Macedonia Mali Myanmar Mongolia Macau Northern Mariana Islands Martinique Mauritania Montserrat Malta Mauritius Maldives Malawi Malaysia Mozambique Namibia New Caledonia Niger Norfolk Island Nigeria Nicaragua Netherlands Norway Nepal Nauru Niue New Zealand Oman Panama Peru French Polynesia Papua New Guinea Philippines Pakistan Poland St. Pierre Pitcairn Puerto Rico Portugal Palau Paraguay Qatar Reunion Romania Russia Rwanda Saudi Arabia Solomon Islands Seychelles Sudan Sweden Singapore St. Helena Slovenia Svalbard And Jan Mayen Islands Slovak Republic Sierra Leone San Marino Senegal Somalia Suriname Sao Tome And Principe El Salvador Syria Swaziland Turks And Caicos Islands Chad French Southern Territories Togo Thailand Tajikistan Tokelau Turkmenistan Tunisia Tonga East Timor Turkey Trinidad And Tobago Tuvalu Taiwan Tanzania Ukraine Uganda U.S. Minor Outlying Islands United States Uruguay Uzbekistan Vatican City State St. Vincent & The Grendadines Venezuela Virgin Islands - British Virgin Islands - U.S Viet Nam Vanuatu Wallis And Futuna Islands British West Indies Western Samoa Wales Scotland Gaza Northern Ireland Held Territories Indian Ocean Islands Yemen Mayotte Yugoslavia South Africa Zambia Zimbabwe Phone: * Cell Phone: Fax: E-Mail Address: * Alternate Contact: Alternate Contact's E-mail: Website Address: (Do not include "http://".) Primary focus of your business:

Membership fees vary depending on your status. Please select the appropriate membership level from the table below. If you are a financing source, please indicate the amount of non-prime outstanding loans serviced by your organization annually:   Membership Status *    Annual Dues    Full Member - Financing Source*     $0 - $19,999,999   $20,000,000 - $24,999,999   $25,000,000 - $29,999,999   $30,000,000 - $34,999,999   $35,000,000 - $39,999,999   $40,000,000 - $44,999,999   $45,000,000 and above   $2,000   $2,500   $3,000   $3,500   $4,000   $4,500   $5,000     Full Member - Dealer   $1,500     Associate Member   $1,250 * NON-PRIME OUTSTANDINGS PLUS SERVICED LOANS Preferred method of payment: *    Check    Visa      MasterCard    American Express Please match the code displayed above:    * Indicates a required field.