REGISTRATION FORM
All Information is sent to the
President. Its kept in a file as
Formal Enrollment.
Name
Scene Name
CB Handle
Hobbies or Pass times
Phone (optional)
In 100 words or more, tell us why,
you want to join the National and
International Women's Trucking
Association.
Are you Male or Female?
How Active do you want to
be in the WTA? (It has no
effect on your membership)
Moderately
Active
Supportive

How Long have you been Trucking?
OR How long have you contemplated
Driving a Truck? How much Training
have you had already if you are
already in training?
What kind of jobs (NOT WHERE),
have you done before?
What State, Providence, or Country
are you from?
Your Email address
Vote for me in


Pro
Active