2008
NAME _____________________________ PHONE ______________________
COMPANY _____________________________ FAX ______________________
ADDRESS _____________________________ E-MAIL ______________________
_____________________________ YAHOO ID ______________________
_____________________________ BIRTH DATE ______________________
Please
state the type
of distribution and
for which gas
liquid products you
coordinate movement:
____________________________________________________________________________________________
GET
INVOLVED!! The
following committees will need members – please indicate those on which you
would like to serve:
House ____________________ Program/Membership _________________
Golf ____________________
Program
and Speaker ideas: ___________________________________________
Signature ___________________________________
v
Please return this form and annual dues of $25.00 payable to the GLDA to the above
address by Wednesday, February 29, 2008 in order to receive all bulletins
for the 2008 meetings and GREAT
activities.
v
THE
ANNUAL FEE FOR APPLICATIONS RECEIVED AFTER THE ABOVE DATE WILL BE $35.00 –
UNLESS THE APPLICANT IS NEW TO THE INDUSTRY.
v
Please pass this application on to any new
prospective member.
At coming events sponsored by the GLDA, alcoholic beverages may be made available for participants discretionary consumption. Upon submission of this membership application, the GLDA hereby expressly disclaims any liability whatsoever that may arise from any participant's consumption of alcoholic beverages and any claims, losses, damages, causes of action, suits, and liability of every kind, whether willful or negligent, for injury to or death of any person, including any participant, or for damage to any property, arising out of or in connection with any participant's discretionary consumption of alcoholic beverages or for any other reason.