Affiliate Representative - Established MEIAR Offic

Instructions

1. Complete all required fields. When completing the office field: begin typing and find your office name in the drop down list. If you do not see your office name in the list please call the Association office at (765)747-7197. If you do not select your office name from the drop down menu your application will not be processed.

2. Be prepared to upload your professional digital photograph and logo during the application process.

3. Allow 72 hours after application has been received by MEIAR for processing.

Note: Membership applications will not be processed without photograph, valid email address, and payment.

If you have any questions please contact MEIAR staff at (765) 747-7197.

Select Your Option(s)

Affiliate Representative - Established MEIAR Office Application $100 Annually

Complete this application if your office location is an established member of MEIAR.

Affiliate membership will include listing of company and representative information on the MEIAR roster. Affiliates are invited to all Association functions including membership meetings, golf outings, bowling tournaments, holiday parties etc. Membership also includes various advertising opportunities we reserve for our affiliate members only.

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameOffice Name

Please select a valid membership option and fee item if exist