It Pays to Join!

If you are an existing member, please fill out the form below anyway. We are currently updating our membership records. Thanks for your cooperation! I/we hereby apply for membership in Service Station Dealers of Greater New York, Inc. whose purpose is: to foster fair standards of business practice in all branches of the automotive retail service industry; to foster legislation — local, state and national of benefit to its members; to disseminate such information as is of benefit and vital to its members and the motoring public.

Business Name
Business Address

City/Town
County
ZIP Code
Phone Number
Primary Email
Is this business a (Select):
Name of Owner or Operator
Owner/Operator Address

Owner/Operator State
Owner/Operator City
Owner/Operator Zip Code
Brand of gas sold at this location:
Repair Shop Number
Is this business a repair shop only?	Yes No
Is this business a gas station with a convenience store?	Yes No

Add medical insurance to billing?	Yes No
Add DBL to billing?	Yes No
Membership Start Date*:
*Dues fee is payable four months in advance upon signing then monthly
Terms & Conditions
I understand and agree that this application is for membership in the Service Station Dealers of Greater NY, Inc. at the prevailing monthly membership rate. I am responsible for the dues each month unless I notify the Service Station Dealers of Greater NV, Inc. in writing 30 days in advance that I no longer desire membership. All outstanding dues, fees, premiums and moneys due must be paid upon cancellation. As the owner of or a principal in the member business herein, I guarantee that any and all moneys due Service Station Dealers of Greater NY, Inc. will be paid and paid in a timely manner. Dues fee is payable four months in advance upon signing then monthly.
I agree to the above Terms & Conditions Yes No

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