2014 SCCA Directory

2014 SCCA Directory
Please complete all information listed below for the 2014 Directory & Buyers Guide. All forms are due February 28,
2014. Please send all completed information to nsoulages@sccaweb.org. You may also submit this form through our
website at www.sccaweb.org.
Please indicate Membership type:
Signatory Member
Affiliate Member
ADR Member
COMPANY______________________________________________________________________________________
ADDRESS_____________________________CITY________________________________ZIP__________________
PHONE (____)________-________________________ FAX (_____)________-_______________________________
E-MAIL________________________@_______________________________________________________________
WEBSITE: http://_________________________________________________________________________________
CONTACT_________________________________________TITLE________________________________________
CERTIFIED BUSINESS DIRECTORY:
(Please check all that apply)
DBE (Disadvantage Business Enterprise)
SBE (Small Business Enterprise)
VSBE (Very Small Business Enterprise)
WBE (Women-Owned Business Enterprise
MBE (Minority Business Enterprise)
DVBE (Disabled Veteran Business Enterprise)
OTHER: _______________________________
ACCOUNTING INFORMATION
To better assist our Accounting Department and to further ensure invoices, receipts, payments, etc. are sent to the
correct individual, please provide contact information for your Accounting Department.
CONTACT: ___________________________________ EMAIL: __________________________________________
Check box if Phone and Fax number are the same as above.
PHONE: (_____) ____________________________ FAX: (____) __________________________________________
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EVENT INFORMATION
Please provide contact information for the following event categories:
Membership Meetings
Check box if same as above
CONTACT:________________________________ EMAIL: ________________________________________
SCCA President’s Gala / PAC Auction / Membership BBQ
Check box if same as above
CONTACT: _______________________________ EMAIL: ________________________________________
SCCA Golf Tournaments
Check box if same as above
CONTACT: _______________________________ EMAIL: ________________________________________
Education & Training
Check box if same as above
CONTACT: _______________________________ EMAIL: ________________________________________
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