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AVDA Application

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General Information
Company:
Primary Contact:	Title:
Alternate Contact:	Title:
Address:
City:	State/Province:
Zip/Postal:	Country:
Phone:
Fax:
E-mail:
Web Site address:
Type of Business:
Sponsoring Member:
Type of Membership:	Active Membership Affiliate Membership Associate Membership
Criteria for Active Membership: Provide proof of existence as a separate entity (Tax ID Number, Checking Account, Certificate of Business, etc.) whose primary source of income is from documentation. Minimum of two consecutive years of experience required. Attach a brief resume detailing what this w/ experience encompasses (time spent working with Coast Guard forms, amount of time spent preparing vessel files for closing, for filing with the Coast Guard, kinds of vessel files worked on; verification of coordination with brokers, owners, banks, etc.) Written references: one from a current active AVDA member and one from a marine-related entity. Proof of E & O Insurance applicant has detailing the coverage included and effective dates; attach a copy of declaration page. I state that I am of good moral character and that the named applicant conducts its affairs in an honest, trustworthy and reputable manner; applicant has not been convicted of a crime of moral turpitude. Criteria for Affiliate & Associate Membership: Written referral from a current active AVDA member. I state that I am of good moral character and that the named applicant conducts its affairs in an honest, trustworthy and reputable manner; applicant has not been convicted of a crime of moral turpitude. Proof of E & O Insurance if providing Coast Guard documentation services (Associate Membership)
Supplemental Information
Other Affiliations:
Other Office Address:
Alternate Phone:
Alternate Fax:
Interest/ Hobbies:
Other Information
Comment:

Member Type Annual Due New Application Fee (One Time) Total

Active Member: $150 $100 $250

Affiliate Member: $250 $100 $350

Associate Member: $500 $100 $600

Please mail your payment to:
American Vessel Documentation Association, Inc.
833 Dover Drive, Suite 15, Newport Beach, CA 92663