Northwest Log Truckers Cooperative

Member's Information

Name:_________________________________________________

Address:_______________________________________________

Phone Number:_________________________________________

Cell Phone:____________________________________________

Fax Number:___________________________________________

E-Mail Address:________________________________________

Owner Operator:_______________________________________

Company Name:________________________________________

Hauling For:___________________________________________

Date & Amount Paid:____________________________________

Please mail completed form and payment to:

Montana Chapter members:

Joe Keller
2210 Mt.Hwy.35
Kalispell Montana 59901

Other chapter members:

Jim Nielsen
42222 252nd Way S.E.
Enumclaw, Washington 98022

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