Member Registration

AFSA Schuylkill Chapter

Instructions

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

Application Form

    Contact Information







    Address

    Street




    Mailing Address


    Same as street?YesNo



    Type of Business

    Design & Installation (FS) ContractorResidential Installation (RFSC) ContractorManufacturer/SupplierSystem Design OnlyInsurance IndustryAuthority Having JurisdictionOther




    Current Member


    Are you a current member of the "National" AFSA in Dallas, Texas? YesNo

    Registration Fees

    • Contractors – $250
    • Manufacturers / Distributors – $350
    • Auxiliary / RFSC – $250
    • AHJ – No Charge

    Sponsors

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