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NC Public Transportation Online Dues Membership/Renewal Form

READ THESE INSTRUCTIONS CAREFULLY BEFORE FILLING OUT THE FORM

Step 1: Submit Information Form and watch for email confirmation. Check your Spam/Junk Mail folder as well.

Information will be used for the Membership Directory.To avoid disruption of information services during the fiscal year, please notify NCPTA at info@nctransit.org of any email address changes.

Step 2: Payment - If paying online, use the "Pay Online" button on the online THANK YOU PAGE that will appear.

If paying with online invoice, select "Online Invoice Needed" if your System operating budget is over $4.5 Million.

If paying by mail, print confirmation e-mail you will receive and mail in with fees to the address in the email.

All fields are required unless noted.

Payment Method

Now (default method)

Member Information

Organization
 Organization is required.
If individual member, type your name.
Organization Web Address:
http:// Your Organization Web site is required. If you are an individual, please type: "Individual"
Membership Address:
Mailing Address
Enter your mailing address.
City City is required.
State State is required.
Zip code 5-Digit Zip code is required.5 digit code format.
Phone Phone Number is required. Invalid format. Example: 919-555-1212 ex. 919-555-1212
Fax ex. 919-555-1213
General Organization email Invalid format.
Primary contact:
First Name
 First Name is required.
Last Name
 Last Name is required.
E-mail Address:
 Primary contact e-mail is required. Invalid format.
Additional contact 1: (optional)
First Name
Last Name
E-mail Address:
 Invalid format.
Additional contact 2: (optional)
First Name
Last Name
E-mail Address:
 Invalid format.
Affiliate Information:

For Affiliates:
Description of your products and/or services:

 


Associate Member Descriptions:

Affiliate: All entities providing goods and services including COG’s, MPO’S, RPO’s.

Corporate Agency: Includes Universities and other educational/research facilities.

Other Transit Industry: Includes private bus companies & private transit advocates.

Non-Profit Agency: Agencies not providing transportation.

Individual: Independent person not working in transit industry.

Check your DUES AMOUNT and enter here.
This amount is be shown on your email confirmation and registration records. Please make sure it matches your cart.

If paying by mail, please note "Dues Renewal" in the memo of check or money order.
Return completed application and check to:
NCPTA
PO Box 72048
Durham, NC 27722-2048

If this page doesn't give you a "thank you" message after you click submit, scroll UP on this page to see if you included answers to all required fields or view to error message by field with error. You will proceed to checkout on next screen.