Rack Pricing Program Sign-Up Form

Please print, complete and return via fax to: 651-487-2447

or by US Mail to: MSSA, 2862 Middle Street, Little Canada, MN 55117

Name

Business Name

Address

City/State/Zip

Phone/Fax

Please create a User ID and password of your choice.

User ID:

Password:

E-Mail:

(A confirmation will be sent to your e-mail address when your ID and password are ready to access information.)

Payment Information

___ Check Enclosed ___ Credit Card: #________________________ Exp_____

$300 annually

Signature (required):