Associate Vendor Application Terms Your Contact Info Business Contact Info Other Business Info Review Order Number Terms of Associate Vendor Membership The specified business is not engaged in the business of lighting sales, manufacturing, distributing, or hold interest in any company that is engaged in the lighting industry in a way that would qualify under the Vendor or Distributor Membership Categories. The specified business maintains, in the United States of America or the Dominion of Canada, a warehouse, office or similar facility in a physical location, zoned for commercial or industrial purposes by the municipality wherein such facility is located. The specified business has been an existing business entity, in the United States or the Dominion of Canada, for at least three (3) full calendar years prior to the date of application. The specified business will, upon recommendation for NAILD membership, pay the required dues, $2,650 annually, as set forth herein. NAILD membership is not transferable. Information provided herein will be submitted for review to the NAILD Board of Directors in connection with this application for membership. Information provided herein remains strictly confidential. 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 * – Select Province/State – Alberta British Columbia Manitoba New Brunswick Newfoundland and Labrador Nova Scotia Northwest Territories Nunavut Ontario Prince Edward Island Quebec Saskatchewan Yukon ==================== Alabama Alaska Arizona Arkansas California Colorado Connecticut Delaware District Of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming Zip / Postal Code * Other Business Info Name of Sole Owner, Partners, or Principal Officers / Directors * Total Years in Operation * Is the Business engaged in selling, distributing, or manufacturing lighting products? * Yes No The major focus of your business is: * Business Interests (mark all that apply) * Advertising Exhibiting at the NAILD Annual Convention Lighting Distributor References (if applicable) Distributor Company #1 Distributor #1 Contact Name Distributor #1 Email Distributor #1 Phone Distributor Company #2 Distributor #2 Contact Name Distributor #2 Email Distributor #2 Phone Distributor Company #3 Distributor #3 Contact Name Distributor #3 Email Distributor #3 Phone Distributor Company #4 Distributor #4 Contact Name Distributor #4 Email Distributor #4 Phone Distributor Company #5 Distributor #5 Contact Name Distributor #5 Email Distributor #5 Phone Message / Comments Review & Submit Your Contact Info Business Contact Info Other Business Info
