Company Name Trading Name ABN Contact Person Job Title Street Address Mailing Address Phone Moile Contact Email Website Please select the industry sector your business is most involved in: Bulk commodity transportConstructionContract logisticsDangerous goodsEarthmoversExpressFuelGeneral freightLivestockLocal distributionLong distance haulageOSOM/Heavy haulageRailRefrigerated haulageSteel cartageVehicle transportWharf cartageOther Details required for those applying VTA membership: Number of employees (approx.) Number of sub-contractors (approx.) Number of trucks (if less than 3 must be Associate Member) Number of sites Turnover Warehousing Ops YesNo State/territories operated in ACTNSWNTQLDSATASVICWA Tick here if new VTA member does Not wish to be a member of the Australian Road Transport Industrial Organisation (ARTIO) VIC branch YesNo Privacy statement: The VTA collects information about your company in order to manage and maintain your membership. Contact information will be used by the VTA and its contractors to provide information about events, training opportunities, news and key issues effecting the transport and logistics industry. Your contact information will not be released to any third parties without your prior consent.