ADVERTISING APPLICATION
Upon return of this application and payment of the yearly advertising fee you will have exclusive rights to all referrals generated by NTAN in the counties you select.
Name _______________________________________________
Address ____________________________________________
City, State ________________________________________
Zip Code ___________________________________________
Phone Number _______________________________________
Fax Number _________________________________________
Toll-Free Number ___________________________________
Email Address ______________________________________
Website ____________________________________________
The National Traffic Attorney Network is a free service offered to truck drivers and to the driving public in general via the internet.
List the counties in which you want to receive referrals from in the spaces provided below. (Check the network to make sure the ones you want are not already taken.)
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I certify that I am licensed to practice law in the state of __________ and that by signing this document and remitting the membership fee, I give the National Traffic Attorney Network permission to give the above information to persons who wish to receive legal assistance in the counties I listed.
Signed, ___________________________________