Standing Together For A Stronger Collision Repair Industry in Nebraska

[print-me] click this if you want to print out the blank form to mail it in

Company Name :
Primary Contact :
Business Address :
City :
State :
Zip :
Phone Number :
Fax Number :
Email Address
Year Business Was Established :
# of Employees :

[print-me] Click to print out the form before you hit send

After signing up for your 2017 Membership, please remit payment of dues, according to this dues structure.

0-4 employees_______________   $130

5-10 employees_______________$170

11  plus employees______________$225

1 Affiliate ___________________$300

If you prefer to mail your check today send to:

Nebraska  Auto Body Association

P.O. Box 4483    

Lincoln, NE 68504 
Any questions, comments, suggestions, please 402-937-6960


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