Membership

Online Application

Company Name(Required)

Representative Name(Required)

First Last

Email(Required)

Phone(Required)

FAX

Billing Address(Required)

Street Address City State ZIP Code

Membership Type(Required)

Carrier Member

Associate Member

Carrier Membership Level(Required)

Carrier Minimum

Mid-Level I Carrier

Mid-Level II Carrier

Max-Level Carrier

Associate Membership Level(Required)

Associate Minimum

Mid-Level Associate

Max-Level Associate

Download PDF Application

Membership Levels

Membership Level	Annual Fee
Carrier Minimum	$350
Mid-Level I Carrier	$450
Mid-Level II Carrier	$675
Max-Level Carrier	$1,450
Associate Minimum	$350
Mid-Level Associate	$450
Max-Level Associate	$575

Drug Consortium Application

To participate in the drug testing consortium, your company must be a current Rhode Island Trucking Association member. A $50 registration fee is due at the time of enrollment and at annual renewal.

Company Name(Required)

Address(Required)

Street Address City State ZIP Code

Designated Company Rep (DER)(Required)

First Last

DER Email(Required)

DER Phone(Required)

DER FAX

Additional Contact (if any)

First Last

Additional Contact Email

Additional Contact Phone

Program Selections(Required)

DOT

Non-DOT

Testing Authority(Required)

FMCSA

PHMSA

Other

How should random selections, test results and all notifications be sent?(Required)

Email (Preferred)

Website

Postal Mail (Only as last resort)

Random List(Required)

Attach page if additional space is needed.

Employee Name

License Number & State

Name

This field is for validation purposes and should be left unchanged.

Download PDF Application

Rhode Island Trucking Association

Membership

Online Application

Membership Levels

Drug Consortium Application

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