Business Name:

Representative:

Title of Representative:

Mailing Address (include city, state & zip code):

Phone:

Fax:

E-mail:

	Bus or chassis manufacturer or distributor
	Vehicle commponents, tires and accessories manufacturer or distributor
	Facilities and shop equipment manufacturer or distributor
	Petroleum products manufacturer or distributor
	Other manufacturer/distributor
	Vehicle or vehicle components service firm: maintenance & repair, towing, tire service, cleaning, etc.
	Facilities and shop equipment service firm, maintenance & repair, custodial, security, etc.
	Consultant, engineering, computer service, other administrative or office services
	Financial, insurance, leasing and related services
	Computers, software, etc.
	Other

YES! Please enroll me as a CASTO member for the coming year (July 1 through June 30). I have checked the appropriate dues category and indicated my desired method of payment

AMOUNT OF DUES:
$250 - Sustaining Member

CREDIT CARD INFORMATION:
VISA
Mastercard

Name as it appears on the card:

Billing Address (include city, state & zip code):

Card Number:

V-number (back of card, last group of numbers on signature line):

Expiration Date: