2019 Affiliate Registration Form

Company Information
 
Company* State / Province
Contact Name*   Zip / Postal Code*
Address*   Suite / Apt
City*   Country
Toll Free Phone*   Email*:
Website Address   Info About Affiliat
(Less than 90 words please):
 
YOU DECIDE - YOU CHOOSE YOUR TERRITORY AND DO WHAT WORKS FOR YOU! GET THE LATEST INFORMATION ON END OF LIFE LEGISLATION!
Your State / Province   Your Zip / Postal Code*
Select your territory- You must enter the radius miles from your location. ie 25 or 50 miles
By completing this form:
I am applying for accreditation as an Authorized Treatment Facilities based on the guidelines as outlined by GreenVehicleDisposal.com.
I agree to meet all outlined GreenVehicleDisposal.com standards.
I agree to pay the GreenVehicleDisposal.com membership and annual administrative fees.
 
Moreover, I agree to adhere to:
Be an active member of GreenVehicleDisposal.com by following all membership requirements and procedures.
If any training seminars/workshops were to arise that contributed to the betterment of GreenVehicleDisposal.com in terms of procedures and codes of conduct, I will attend or send a representative in my place.
Take any opportunity to enhance the customer service, quality and reputation of GreenVehicleDisposal.com, that will directly contribute to the betterment of my institute.
I understand that the automotive industry is constantly changing and adapting to new technologies and procedures, as such, I also understand the requirements of my institute as an GreenVehicleDisposal.com affiliate may also change.
   
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