Join The Ford Managers Association On-Line

Please provide the following contact information:

	Your Name
	Your Title
	Company Name
	Street address
	Address (cont.)
	City
	State/Province
	Zip/Postal code
	Country
	Work Phone
	FAX
	E-mail

Which Association Do You Want To Join?

Ford Parts Managers Association (FPMA)
Ford Service Managers Association (FSMA)
I Want To Join Both ($100 Dual Member Discount)

Enter The Membership Price That Applies To You.

FPMA (Yearly Parts Sales Under $500,00) $149 Per Year FPMA (Yearly Parts Sales $500,00 to $1,000,000) $199 Per Year FPMA (Yearly Parts Sales Over $1,000,000 $299 Per Year FSMA Membership $299 Per Year Dual Member With $100 Discount $498 Per Year FPMA NON-DEALER $299 Per Year FSMA NON-DEALR $299 Per Year

How Will You Pay For Your Membership?

Check
Company Purchase Order
Credit Card

If Using A Credit Card Tell Us Which One.

Visa
Master Card
American Express

If Using A Company PO, Enter Purchase Order Number Here

Please Enter Your Card Number (Please Be Careful When Entering Number)

Enter Expiration Number Of Card

-- mm/dd/yy

Please Enter Name On Card