Membership Form "*" indicates required fields Company Name* Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Phone*FaxEmail* Website Company Representative* First Last Title* HiddenDescriptionAnnual DuesAnnual Dues* FULL MEMBER -Based on number of employeesOcean Transportation Intermediary (Freight Forwarder or NVOCC) and/or a Customs Broker who regularly transact business through the Port of New York/New Jersey. AFFILIATED MEMBER $500 Affiliated members shall consist of persons, firms, partnerships, or corporations who are engaged in a business related to international trade services but are not licensed as per Full Member requirements. Such affiliate members may attend general membership meetings, but may not vote, hold office or have an interest in the property of the Association. SUBSCRIPTION MEMBERS $200 Out of state brokers/forwarders wanting to receive email distributions and alerts By Number of Employees* 1-19 - $475 20-59 - $650 60 or more - $850 To be eligible as a voting member of the Association, the applicant must be authorized to carry on the business of ocean or air freight forwarding, non-vessel operating common carriage, or Customs brokerage by the agency having jurisdiction over such activity. Membership shall automatically cease if a member is no longer authorized to act as an ocean freight forwarder (OTI-1), air freight forwarder (IAC), non-vessel operating common carrier (OTI-2), or Customs broker (CHB), or is no longer engaged in such business.Please check all categories that apply: Ocean Transportation Intermediary Customs Broker Air Freight Forwarder/Air Cargo Agent FMC Number CHL Number NCBFAA Member Number of years in business as an OTI or Customs Broker Date & State of Incorporation HiddenMember TypeAffiliate MemberCounsel to the AssociationFull MemberSubscription MemberAgreement* We hereby make application for membership in the NY/NJ Foreign Freight Forwarders and Brokers Association, Inc. and if accepted, agree to abide by the By-Laws of the Association and all duly passed resolutions.Signature* Reset signature Signature locked. Reset to sign again Signer's Name Title Representative at NY/NJ FFF&BA meetings if different than aboveName Position Email ReferencesPlease list one current memberName* Position* Email* Credit Card American ExpressDiscoverMasterCardVisaSupported Credit Cards: American Express, Discover, MasterCard, Visa Card Number Expiration Date Month Month010203040506070809101112 Year Year20232024202520262027202820292030203120322033203420352036203720382039204020412042 Security Code Cardholder Name Membership subject to Board Approval.
