Member Registration

AFSA Mid Atlantic Chapter

Instructions

Please submit the following form to begin the member registration process.

Application Form

Contact Information







Address

Street




Mailing Address

Same as street? Yes No



Type of Business

 Design & Installation (FS) Contractor Residential Installation (RFSC) Contractor Manufacturer/Supplier System Design Only Insurance Industry Authority Having Jurisdiction Other




Current Member

Are you a current member of the "National" AFSA in Dallas, Texas?  Yes No

Registration Fees

  • Contractors – $200
  • Manufacturers / Distributors – $300
  • Auxiliary / RFSC – $200
  • AHJ – No Charge

Sponsors

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