Join The NYELSA

Thank you for your interest in membership with the New York Electronic & Life Safety Association. If you would like more information, or would prefer to apply over telephone, please email, or give us a call. We're here to help, and look forward to meeting you soon!

Sincerely,

Jack Doyle

President

Application Form

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Name(Required)

First Last

Phone(Required)

Email(Required)

Company Name(Required)

Website

Company Type(Required)

I am interested in the following committees:

Convention/ Annual Meeting

Membership

Licensing & Compliance

Training

Scholarship

Department of State Liaison

Government Relations

Communications and Technology

Regular Membership shall be open to any individual, partnership, firm, corporation or business entity within the State of New York which shall meet the following requirements: 1. Have its major activity in the electronic security industry, the installation and servicing of burglar alarms, fire alarms, supervisory systems and other electronic systems. 2. Have a valid New York state license to operate in the electronic security industry. General Requirements: All members must be willing and agree to conduct their business in accordance with the Code of Ethics, and bylaws.

Company Address(Required)

Street Address Address Line 2 City State ZIP Code

File Upload(Required)

Drop files here or

Accepted file types: jpg, gif, pdf, doc, docx, Max. file size: 2 GB, Max. files: 10.

Please Upload Copies of All Company Licenses.

Your primary and alternate voting representatives will represent your company in all association voting matters. Representatives provided will receive electronic and printed member communications from the association.

Name of Primary Voting Representative(Required)

First Last

Title(Required)

Phone(Required)

Email(Required)

Address(Required)

Street Address Address Line 2 City State ZIP Code

Name of Alternate Voting Representative

First Last

Title

Phone

Address

Street Address Address Line 2 City State ZIP Code

Member dues are $300/yr. The Association accepts Visa, Master Card, American Express or Net 30 terms. Please make checks payable to: NYELSA. Membership is not transferable. Dues are not refundable. Membership is based on a calendar year (January 1 thru December 31).

Invoice Net 30 or Credit Card?(Required)

Name on Invoice(Required)

First Last

Email Invoice To:(Required)

Phone(Required)

Address to Mail Invoice To:(Required)

Street Address Address Line 2 City State ZIP Code

Name on Credit Card(Required)

First Last

Credit Card Number(Required)

Expiration Date(Required)

Month/Year

CVV(Required)

Signature(Required)

An Associate Member is defined in the NYELSA Bylaws as “ any individual or duly licensed business entity engaged in manufacturing, distributing, supplying, dealing in, or selling products or services generally used, relating to, and/or necessary to the members of the Association.” Each Associate Member shall have the right to one vote to elect the Board of Directors. The Annual Dues for Associate Members are $275.

Names/E-mails of people in your company who would like to receive NYELSA newsletters and notices:

Associate Name #1

First Last

Associate Email #1

Associate Name #2

First Last

Associate Email #2

Associate Name #3

First Last

Associate Email #3

Please Note: Payments or contributions to NYELSA are not deductible as charitable contributions for federal income tax purposes. Payments may be deductible as a business expense. Please consult your tax advisor. The Association accepts Visa, Master Card, American Express or Net 30 terms. Please make checks payable to: New York Electronic & Life Safety Association.

Associate Dues: Pay Today via Credit Card or Invoice Net 30?(Required)

Name for Credit Card / Invoice(Required)

First Last

Address for Credit Card / Invoice(Required)

Street Address Address Line 2 City State ZIP Code

Phone for Credit Card / Invoice(Required)

Email for Credit Card / Invoice(Required)

Credit Card Number(Required)

Expiration Date(Required)

Month/Year

CVV(Required)

Signature(Required)