Get Membership Application - Ipca - Ipca

Filling out the MEMBERSHIP APPLICATION for the Indiana Petroleum Marketers and Convenience Store Association (IPCA) online is a straightforward process that helps streamline your membership registration. This guide will help you navigate each section of the application efficiently and ensure that all necessary information is provided accurately.

Follow the steps to successfully complete the online application.

1. Click the ‘Get Form’ button to obtain the form and open it in the editor.
2. Select your membership type by choosing one of the provided options: Associate Member, Refiner/Alternative Member, Supplier Member, or Refiner/Conventional Member.
3. Decide if you would like to join the IPCA President’s Council by answering 'Yes' or 'No.'
4. Enter your company name in the designated field, along with any Doing Business As (DBA) name if applicable.
5. Indicate how you would like your company listed in the Membership Directory by selecting either 'As Company' or 'As DBA Listing.'
6. Provide the main contact person's full name in the specified field, ensuring that no initials are included.
7. Fill in the title of the main contact person and the mailing address, making sure to include the complete information.
8. Enter the contact phone number, fax number, and email address in the appropriate fields.
9. Specify the county where your business is located and include the website URL, if applicable.
10. State your home address zip code if requested, and indicate if you have been a member of IOMA/IPCA before by selecting 'Yes' or 'No.'
11. If you were a member previously, provide the name under which your company was listed.
12. Enter the name of the person who recommended you for membership, along with their company name.
13. Choose the category that best describes your business from the list provided, ensuring that you only select one.
14. Complete the payment section by entering your credit card number, amount due, expiration date, security code, and signature on the card.
15. After completing all sections, review the information for accuracy before saving changes, downloading, or printing the form.
16. Submit your application by faxing it to the provided number or mailing it to the address listed, along with the payment.

Start your membership application online today!