Membership Application

2024 MLA Membership Dues Schedule:

Operators and Affiliate Operators: $150
Vendors: $500

ON-LINE Application and Payment. Easy 2-step process: On-line application below.

STEP 1– Complete the MLA application below. Once complete, you will be directed to the PAY NOW page to pay for the 2024 Membership dues.

STEP 2– Complete PayPal payment.

Once we have received both MLA Application and payment, your membership is PENDING until your Operator’s authority is verified. Once verified, you will be emailed a WELCOME ABOARD email!

OR

PRINT and MAIL: Download and print: 2024 MLA Membership Application and mail it with your check payment. (USPS Mailing instructions are on MLA application.)

Membership Type

NEW Applicants: How were you referred to the MLA? (Please name your referral.)

Company's Legal Name

DBA (Will appear on website.)

Primary Contact Name (Will appear on website.)

Company Address

City

State

Zip

Telephone (Will appear on website.)

Cell (Will NOT appear on our website.)

Primary Email (Will appear on website.)

Secondary Email (Will NOT appear on website.)

Web Address (Will appear on website.)

Number of Years in Business

Membership in Other Industry Association?

Vendor's Membership

Product(s) of Service(s) Offered

Operator's / Affiliate's Membership

Total Number of Vehicles in Your Fleet

Check the appropriate box to indicate all vehicle types in your fleet
SedanSUVStretchStretch-SUVShuttleBusHybridSpecialtyWheelchair Accessible

Primary City You Service

Secondary City You Service

Insurance Provider (Operators and Affiliates)

MD PSC # (Maryland Operators Only)

If you are operating one or more commercial motor vehicles in interstate and/or intrastate commerce are you currently in compliance with all federal and state requirements prescribing mandatory minimum levels of public liability insurance coverage?

Are you currently in compliance with all federal and state motor carrier operating licenses certificate or permit requirements?

I understand that my application to be an MLA Operator Member is PENDING until verification of my authority’s licensing and insurance requirements.

PalPal Payment must be paid along w/ the MLA application. (Once you SUBMIT MLA Application, a PayPal page will Pop-up for you to complete.)

OATH: I affirm That all the information contained within is true and correct to the best of my knowledge

Please Confirm This Oath By Signing Below.

Electronic Signature

Date