Become a Member Membership Application Step 1 of 3 - Membership Type 33% What type of membership are you signing up for?*Regular MembershipAssociate Member (Equipment & Supply)Associate Member (Major & Wholesaler)Convenience Stores / Motor Fuels All petroleum marketers who sell heating fuels or motor fuels at retail fall into this category. DUES: Based on 0.0008257 cents per gallon on the 1st 10 million gallons. MIN DUES: $518.00 per year (for those companies who sell less than 350,000 gallons) MAX DUES: $15,195.00 per year 13% is added to all dues in this category to pay for MEMA’s membership with the Petroleum Marketers Association of America (PMAA). All companies that do not sell heating oil or propane at retail, and do not sell petroleum products at wholesale, fall into the Associate Member – Equipment & Supply category. Membership dues are based on the number of employees the company has, as follows: 1-15 Employees = $346 ($306.00 + 13% PMAA Dues) 16+ Employees = $692 ($612.00 + 13% PMAA Dues) There is an additional surcharge on dues for members in this category who join the MEMA Health Insurance program. *13% is included in dues in this category of membership to pay for MEMA’s membership in the Petroleum Marketers Association of America (PMAA). All companies who primarily sell motor fuels fall into the Associate Member – Convenience Store category. MEMA dues are based on the number of stores owned: 1-3 Stores = $250.00 + 13% PMAA Dues 4+ Stores = $50 per store (over 3 stores) + 13% PMAA Dues No additional fees apply to this category of membership. All companies who do not sell heating oil or propane at retail, but who do primarily sell petroleum products at wholesale, fall into the Associate Member – Major Oil Co. & Wholesale category. MEMA dues are a flat rate of $3,855, and no additional fees apply. Please tell us how many gallons you sell annually:*Please tell us what your company does?*Please tell us how many employees your company has:*Select Company Size1 - 15 employees16+ employeesPlease tell us how many stores you have:*Please enter a number greater than or equal to 1.Associate Member (Major & Wholesaler) Dues Price: $3,855.00 Associate Member (Equipment & Supply) Dues 1-15 Price: $346.00 1-15 Employees = $346 ($306.00 + 13% PMAA Dues)Associate Member (Equipment & Supply) Dues 16+ Price: $692.00 16+ Employees = $692 ($612.00 + 13% PMAA Dues)Convenience Stores / Motor Fuels (3 Stores or less) Price: $282.50 1-3 Stores = $250.00 + 13% PMAA DuesConvenience Stores / Motor Fuels (4+ Stores) Price: $282.50 4+ Stores = $50 per store (over 3 stores)13% PMAA Dues (4+ Stores) Price: $0.00 0.0008257 x annual gallons soldCalculate PMAASub Total Reg MemberMin Regular Member Dues (Including 13% PMAA Dues) Price: $518.00 Calculated Regular Member Dues Price: $518.00 Total $0.00 Contact InformationPlease provide the contact information for you and your company.Contact Person's Name First Last Company Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Company NamePhone NumberEmail Address* Fax NumberTotal $0.00 PreferencesPlease tell us a little bit more about what benefits your most interested in. Are you interested in finding out more about MEMA's Group Health Insurance Plan? Yes Are you interested in finding out more about MEMA's Workers' Compensation Plan? Yes Questions / CommentsTotal $0.00 Payment Options*Pay PalSend A Check Please make checks payable to Maine Energy Marketers Association Address: Maine Energy Marketers Association 25 Greenwood Road Brunswick, ME 04011 CommentsThis field is for validation purposes and should be left unchanged. This iframe contains the logic required to handle Ajax powered Gravity Forms.