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ATRA
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Oxnard, CA 93030
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ATRA Preferred Pricing Program Membership Sign-Up Form If you are interested in becoming a member of the P3 (Preferred Pricing Program) by offering products or services at a discount, please complete the form below and you will be contacted by an ATRA Membership Services Representative. * Indicates Required Field

Account Number:	*
First Name:	*
Last Name:	*
Title:	*

Company Name:	*
Street Address:	*
City:	*
State:	*
Zip Code:	*
Country:
Telephone:	*
Email Address:	*
Web Site Address:	*

What is your primary product line? (Please check all that apply): * General Transmission Parts General Auto Parts Manufacturer Specific Parts Remanufactured Transmissions Used or Rebuilt Parts Shop Supplies Transmission Additives Marketing Specialties Other if "Other", please describe

What types of payment programs do you accept? (Please check all that apply): * Cash Regular Billling Account Other (Specify) Credit Cards Visa MasterCard American Express Discover Other Credit Cards (Specify)

What type of discount will you offer ATRA Members? *

Details, please specify* TERMS OF MEMBERSHIP: YES! I want to become a member of ATRA's Preferred Pricing Program and take advantage of the benefits offered. I agree to provide discount pricing to all ATRA Members, as provided for in this program. I understand that my continued participation in this program is conditional, and may be revoked by ATRA at any time. I AGREE

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ATRA Preferred Pricing Program Membership Sign-Up Form