NDPDA Membership Application

Please print this form and mail to:  (Membership Period:  January 1st to December 31st)
North Dakota Powersports Dealers Association
4120 Memorial Hwy
Mandan, ND 58554

ndpda@midconetwork.com

The North Dakota Powersports Dealers Association offers two classes of membership:  business and associate.    Business members are licensed powersport dealers and the membership is $100/year.  A licensed powersport dealer has paid the required fees to the North Dakota Department of Transportation and is registered with the state.  Associate members are associations, organizations, or departments managing and supporting motorized recreation and the membership is $50/year.

Select a class of membership:
Business Membership:___________
Associate Membership:___________

Contact Person: _____________________________

Business Name: _____________________________

Address: __________________________________ County: __________________

City: ______________________ State/ZIP: _________________

Email: _________________________________  Website: __________________________

Business Phone: _________________________________

Enclosed Fee:__________________

What products do you carry?

Which manufacturers do you carry?