IMDA Membership Directory Order Form


Membership Directory Available

Our membership directory is available to manufacturers who are seeking specialty distributors.  The directory lists over 75 firms, covering the entire United States.

Name: ________________________________________
Company: ________________________________________
Address: ________________________________________
City: __________________     State:  _____      Zip:  ____________
Phone: _______________ 
   
Payment Information:
   
___  Enclosed is my $175 check (payable to IMDA).
   
___  Enclosed is Visa, MasterCard or American Express card information.
   
 

Card No.: _____________________________________

Expiration Date: _________________________________

Name on Card: _________________________________

Credit card billing address: _____________________________________________

Signature: _____________________________________

 

To order, please print this page, complete this form, and return with payment for $175.00.

IMDA
414 Plaza Dr., Suite 209
Westmont, IL 60559
1-866-IMDA-YES or 1-866-463-2937
Fax: (630) 655-0391
imda@imda.org