Houston Independent Automobile Dealers Association June Issue: Floor Planning | Page 21

Member Price - $249
Non-Member Price - $499
(each addtn'l $199, must be from same dealership)
Registrant Name:
Additional Registrant(s):
Dealership:
Address:
Street
City/ST/Zip
Phone:
Email:
Check #:
Credit Card: MC
Total Amount: $
VISA
Card Number:
AMEX
DISCOVER
Expiration Date:
CVV:
Name on Card:
Billing Address:
(if different than above) Street
City/ST/Zip
Signature:
For more info call TIADA 512.244.6060 or HIADA 832.604.4355
Or visit www.txiada.org or www.houstoniada.com
Fax completed form to: TIADA 512.244.6218 or HIADA 888.223.6170