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Membership Discount Program Contract

  1. Website Fillable Form Header

  2. Please be specific any conditions of your discount.

  3. Please upload a clear JPEG or PNG image of your logo that the Association may use for advertising.

  4. If "Discontinue" is selected, let us know why so that we may improve the program. Please be sure to honor the previous contract by offering your discount through the specified end date.

  5. Electronic Signature Agreement*

    By checking the "I agree" box below, you agree and acknowledge that 1) your application will not be signed in the sense of a traditional paper document, 2) by signing in this alternate manner, you authorize your electronic signature to be valid and binding upon you to the same force and effect as a handwritten signature, and 3) you may still be required to provide a traditional signature at a later date.

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  7. This field is not part of the form submission.