GODDARD AUTO TECH CENTER MEMBERSHIP FORM

Please fill out the following form in its entirety.  Click "Submit" and print out the resulting page.  Send it, along with a check, to: 

Goddard Auto Tech Center, Code 544, Greenbelt, MD 20771. 

For questions, contact Ken Blumenstock at 301-286-4268. 

New or Renewal: New   Renewal
Last Name:
First Name:
M.I.:
Address:
 
City:
State:
Zip Code:
Home Phone:
Work Phone:
Cell Phone:
Mail Code:
E-Mail Address:
Alternate E-mail:
Category:
If Contractor, Specify:
Orientation Training Completed: Yes No

You must read, understand, and signify agreement with each of the following documents by checking the corresponding box:

I have read, understand, and agree to abide by the GATC constitution, by-laws, and operating rules.
I have read, understand, and agree to abide by the GATC housekeeping and safety procedures.
I have read, understand, and agree to abide by the GATC procedures for handling wastes.

If you have had SWPP training please check the following box:

I have taken Storm Water Pollution Prevention (SWPP) training within the last year.


The membership fee is $25 ($12.50 after Jan 1st) plus the user fee of $20 for those who did not do any volunteer work during the past membership year.  The membership year runs from July 1st thru June 30th.  A late fee of $15 must be added for renewals after August 31.  Parking fees must be current for a new membership card to be issued.  Make checks payable to “GATC.”

Initiation Fee: $75
Membership Fee: $25
User Fee: $20
Late Fee: $15
Parking Fees
Other Fees