Your Name (required)

Mailing Address (required)

Your Email (required)

Your Phone Number (required)

Your Fax Number

Company Name (Note: Membership is by company, not individual)

Indicate whether Corporation, Proprietorship or Partnership. If Corporation, indicate when incorporated. (required)

Select Your Type Of Membership
 Regular ($150) Affiliate ($200)

List your Customs Broker License Number (if applicable)

List your Freight Forwarder, OTI Number (if applicable)

If applying for affiliate membership, list your business service

Year Company Started

If your firm is only located in Baltimore, leave this field blank. If located in other cities other than Baltimore, indicate those locations:

Sponsorship by: (Name of Member Company):

Sponsor's Phone Number

Your name, as representative of the applicant:

Do you wish to receive an email copy of the By-Laws

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