C12 Membership Registration Form

General Business Info

Here a few questions to help us get to you and your company
Name *

Owner Name Business Name
Business Address: *

Street Address

Street Address Line 2

City State

Zip Code
Phone Number *

Area Code Phone Number
Email *
example@example.com
Company Website *
Please type N/A if yourcompany has no website
ARD License #
Date your business was established *

Year Month Day
Date
Start date of current ownership *

Year Month Day
Date
Business Type *

Sole Proprietorship Corporation Partnership Franchise Independent Sales Representative Instructional Other
Services Offered *
What type of work does your company do?
Number of Employees *
Where did you hear about us? *

Current Member Web Vendor Email News Article Other
Membership Agreement

Please read through the following membership below and acknowledge that you understand and agree to the ASCCA Code of Ethics and Membership Pledge
Code of Ethics
1. To promote goodwill between the motorist and the industry.
2. To have a sense of personal obligation to each individual customer.
3. To perform high quality repair service at a fair and just price.
4. To employ the best skilled personnel obtainable.
5. To use only proven merchandise of high quality distributed by reputable firms.
6. To itemize all parts and adjustments in the price charged for the service rendered.
7. To retain all parts replaced for customer inspection, if so requested.
8. To uphold the high standards of our profession and always seek to correct any and all abuses within the automotive industry.
9. To uphold the integrity of all members.
10. To refrain from advertisement which is false or misleading or likely to confuse or deceive the customer
Membership Pledge

I, the undersigned hereby apply for membership in the AUTOMOTIVE SERVICE COUNCILS OF CALIFORNIA, hereafter referred to as ASCCA. I promise to abide by the Constitution, Bylaws and Code of Ethics and all the other policies of the organization duly promulgated by its Board of Directors, including those related to guarantees and advertising. It is expressly understood that, as a condition of my membership, I promise to stand behind the services I perform and the products I sell in accordance with the accepted customs of the industry.

I understand that signs, decals and emblems remain the property of ASCCA and are only leased by me. It is also understood that I am not entitled to ASCCA Member Group bonuses, dividends, rebates, or other financial benefits unless I am a member in good standing at the time that the dividends are distributed. In addition, I understand that until further written notice, I consent to receive facsimile and/or e-mail messages and solicitations from ASCCA, related foundations, for-profit subsidiaries and chapters to the fax number and email address listed on this application. By signing this application, I am further stating that I have the authority to enter into this agreement and to grant contact via one or both of these mediums.

I have read and understand the ASCCA Code of Ethics. Furthermore, I agree to adhere to and abide by the Code of Ethics if I am to remain a member in good standing.

I accept and understand that any member of ASCCA has the right to level accusations against another member of the association for violating the ASCCA Code of Ethics, provided said accusations are made in writing and with a signature affixed.

I understand that should another member accuse me of one or more Code of Ethics violations, I will be afforded due process in the resolution of the accusations, in accordance with the policies and procedures of ASCCA.

I understand that my total annual dues are as stated in this form.

I further understand the amount I have included with this application covers my entry fee.
By my virtual signature, I affirm that I have read, understand and agree to the ASCCA Code of Ethics and Membership Pledge provided above. I also agree to remain a member in good standing. *

I have read, understood, and accepted the rules for membership.
Membership Level

Choose your membership level, and you're all set.
Application Fee

The Application Fee is a one-time fee that includes the initiation of membership in both the state association and the local chapter. The following portion of this form is informational only.

Membership Dues

REGULAR MEMBER

Annual: $780.00
Semi-Annual: $390.00
Quarterly: $195.00
Monthly: $67.00

ASSOCIATE MEMBER

Annual: $875.00
Semi-Annual: $437.50
Quarterly: $218.75
Monthly: $74.92

BRANCH MEMBER

Annual: $630.00
Semi-Annual: $315.00
Quarterly: $157.50
Monthly: $54.50

EDUCATOR MEMBER

Annual: $50.00

** Please note that your payment will be prorated based on the timing of your payment. Ex: If you opt for Semi – Annual payments and are beginning Regular Membership in February, we will only charge for 5 months at $325.00, instead of the full amount of $390.00**
Check below to authorize ASCCA to use your credit card information to automatically renew your dues. *

Monthly Quarterly Semi-Annual Annual I do not authorize ASCCA to use my credit card information to automatically renew my dues
By my virtual signature, I affirm that I have read, understand and agree to the ASCCA Code of Ethics and Membership Pledge provided above. I also agree to remain a member in good standing. *

Clear

Membership Level *

Regular Membership $ 740.00

Regular Membership

Associate Membership $ 930.00

Associate Membership

Branch Membership $ 685.00

Branch Membership

Educator Membership $ 105.00

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Date	Postal Code

Should be Empty:

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General Business Info

Membership Agreement

Membership Level