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| MEMBERSHIP APPLICATION | | | | | Person To Contact:________________________________________________________ | | | Company:________________________________________________________________ | | | Address:_________________________________________________________________ | | | __________________________________________________________________ | | | Phone:______________________________ Fax:________________________________ | | | Signature:________________________________________________________________ | | | Printed Name:____________________________________Date:____________________ | | | Check Enclosed: _____ Please Bill Our Dues of $__________________ | | | | | ANNUAL DUES (JULY 1 - JUNE 30) | | | |
RETAILERS
| DISTRIBUTORS, WHOLESALERS,
MANUFACTURERS
| Sales per store in NM per year:
| Sales in NM per year: | 0 - 5000,000 $200 per store
| New or under 5,000,000 $300 | 500,001 - 2,000,000 $300 per store
| 5,000,001 - 10,000,000 $600 | 2,000,001 & over $400 per store
| 10,000,001 - 25,000,000 $800 | Convenience Store $1,200 total
| 25,000,001 and over $1,200 | Chain Supermarkets $2,000 total
| Brokers $250 | | Maximum Annual Dues Per Company: | | | $1,200 if total retail sales are under $50,000,000 | | $2,000 if total retail sales are over $50,000,000
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Mail Payments To:
New Mexico Grocers Association
4010 Carlisle Blvd. NE Suite A
Albuquerque, NM 87107
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Phone: 505-888-1812
Fax: 505-883-3197
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To Coupon Questionnaire
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