Agency Application – Arkansas Transit Association

Membership Application Form

Agency Membership Application Form

Fields marked with an * are required

Director *

Agency *

Website *

Work Phone *

Work Fax

Cell Phone *

Address *

City *

State *

Zip *

Notes

Recaptcha

Confirm

Confirm

Voting Representative

In the event the agency director is unavailable or chooses to assign voting privileges to another person at the member organization, the director may appoint a Voting Representative. You can sign a Voting Representative by providing the following information.

Voting Representative

Fields marked with an * are required

Name *

Job Title *

Work Phone *

Cell Phone *

Email *

Recaptcha

Training Representative

Please provide the name and contact of the person primarily responsible for training and staff development at your organization. This person will receive periodic correspondence regarding training opportunities available through ATA.

Training Representative

Fields marked with an * are required

Name *

Job Title *

Work Phone *

Cell Phone *

Email *

Recaptcha

Arkansas Transit Association

Advancing public transportation in Arkansas through education, technical assistance and training.

Contact Us