Member Application

Thank you for your interest in joining the County Road Association (CRA) of Michigan. Your membership is the beginning of a mutually beneficial relationship between your company and Michigan’s 83 county road agencies. Your membership gives you insider access to our members that are responsible for the majority of Michigan’s road systems. County road agencies are responsible for 90,000 miles, 5,700 bridges and more than 30 billion square feet of right-of-way in Michigan.

Business Information

Company Name: *

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Phone: *

Website:

Email: *

Business Description (200 char max): *

Comments / Questions:

Member Directories (max. of 6): *

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title:

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Social Networking:

LinkedIn Facebook

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Associate Membership: $395.00
Annual Membership Dues

Payment Option:

Bill me

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