• AMP Program Information:

  Company Name
  Address
  PO Box
  County
  City
  State
  Zip
  Phone
  FAX
  Web address

• Major line or franchise:

• Additional lines carried:

• Do you carry outdoor power equipment?
  Yes
  No

  Major lines

• Do you sell (check all that apply):
  Cars or Trucks
  ATV's or Motorcycles
  Boats
  RV's
  Snowmobiles

• Please describe sales mix:
  Agricultural Equipment - %
  Construction Equipment - %
  Consumer Products - %
  Other (Describe: ) - %

• Number of employees:

  # of Full Time Employees
  # of Part Time Employees

• Branch location(s).   For each branch, list address, city, county, state and store manager:

  Address	City	County	State	Store Manager

• Business Organization
  Choose one of the following options:

  	Corporation
  	Partnership
  	Proprietorship
  	Other

• :

  	Name	E-Mail Address
  Owner
  Owner
  Manager
  Office Manager
  Credit Manager
  Parts Manager
  Service Manager
  Business Forms
  Education/Training/Safety
  Human Resources
  Insurance

• Contact Person (if not owner)

  Name

  Title

• Computer Systems

  Hardware
  	Computer brand, make, model, i.e. Toshiba Tecra 8000
  Software
  	For example: MS Office 2000, Quick Books 2000 etc.

• SouthWestern Association Member Services
  Please send me more information about the following industry-specific services available only to SouthWestern Association Members:

  Accounting Systems & Procedures	Legal Services
  Advertising Specialty Items	Management Incentive Programs
  ATS-GPS Theft Control on Equipment	Marketing/Advertising
  Bankcard Acceptance Program	Mergers/Acquisitions
  Business Forms	On-site Programs
  Business Valuations & Operations Assessment	Exit & Expansion Strategies
  Computer & Technology Analysis & Integration	Financial Training and Education
  Convention/Annual Meeting	Aftermarket Development
  Credit/Lein Manuals [State:	Leadership & Management Training
  Credit Reporting Services	Customer Service Training
  Dealer to Dealer Programs	Professional Selling Skills
  Drug & Alcohol Testing Programs	Succession/Operational Cross Training
  EDCO Inventory & Retail Financing	Regulatory Compliance
  Employee & Management Benefit Program	Retirement/401(k), Profit Sharing
  Employee Policy & Procedure Manuals	Seminars
  Estate Planning	Trade-In Guides
  Group Health, Life & Business Insurance	Web Site Development
  IRON Solutions Products & Services	Other

• Insurance Coverage - SouthWestern Association offers significant savings to members on a number of insurance products.  Please complete the information below to help us serve you:
  Please list current Insurance provider and next renewal date:

Coverage	Current Provider	Next Renewal Date
Group Health (must have 2 or more eligible)
Worker's Compensation
General Liability
Property & Casualty
Dental
401(k) and Profit Sharing
Other: