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SIA Membership Application

 
Section 1: Membership Information
First Name*
  
Initials
  
Last Name*
  
Company
  
Position Title
  
Mailing Address*
  
City*
  
State*
  
Zip Code*
  
Country
  
Work Phone
  
Home Phone
  
Mobile Phone
  
Pager
  
E-mail*
  
Providing your e-mail address allows you to receive timely information from SIA . It is a SIA policy to not sell or distribute e-mail addresses of members.


 
 
Section 2: Select a username and password
User Name*
  
Password*
confirm password 		 
Password must have a minimum of 6 characters.

 
 
Section 3: Referred by SIA Member
Member's Name
  
Member ID#
  
Referral Source   
  Internet
Other
 
 
Section 4: Payment
Membership Type*
 $25.00 - Industry Member: Industry Member
$0.00 - Government: Must meet the following criteria:

Any individual who is employed full time by a U.S. Government agency which regulates, administers, or is otherwise involved in export or import controls or related aspects of international trade, may apply for government membership.
 
Payment Method*
    Credit card
 


 
 

For security reasons,

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