Affiliate Application Your Contact Info Business Contact Info Other Business Info Review Url Your Contact Info Personal First Name * Last Name * Email Address * Phone Number * Job Title * Business Contact Info Business Name * Business Email Address * Phone Number * Website Address Mailing Business Address Line 1 * Business Address Line 2 City * State / Province * Zip / Postal Code * Other Business Info Business Type * Sole Ownership Partnership Corporation Separate Lighting Division Name of Sole Owner, Partners, or Principal Officers / Directors * Total Years in Operation * Annual Gross Revenue * Number of Employees * Number of Locations/Branches * Do you stock & ship inventory from your own warehouse? * Yes No Warehouse Location * Same as office Same as office but unattached *Different Location (list address below) Were you referred to NAILD by someone? If so, who? If not, how did you hear of us? * What are some of your main goals/reasons for joining NAILD as an affiliate? ie. Dark Sky advocacy, join Lighting Controls Council, or to support another lighting movement? * Review & Submit Your Contact Info Business Contact Info Other Business Info
