Lighting Agency Membership ApplicationCompany Name(Required) Company's Main Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Website(Required) A valid URL format is http://www.forexample.com.Market(Required)US MarketsAlbuquerque NMAnchorage AKAtlanta GAAustin TXBaltimore MDBirmingham ALBoise IDBoston MACentral ILCharlotte NCChattanooga TNChicago ILCincinnati OHCleveland OHColumbus OHDallas TXDes Moines IADenver CODetroit MIFresno CAFt. Myers FLGrand Rapids MIGreensboro NCGreenville SCHartford CTHonolulu HIHouston TXIndianapolis INJackson MIJacksonville FLKansas City MOKnoxville TNLas Vegas NVLittle Rock ARLos Angeles CALouisville KYMemphis TNMiami FLMilwaukee WIMinneapolis MNNashville TNNew Orleans LANew York NYNewark NJNorfolk VAOklahoma City OKOmaha NEOrlando FLPensacola FLPhiladelphia PAPhoenix AZPittsburgh PAPortland MEPortland ORRaleigh NCReno NVRichmond VARochester NYSacramento CASalt Lake City UTSan Antonio TXSan Diego CASan Francisco CASavannah GASeattle WASpokane WASt. Louis MOTampa FLToledo OHVentura CAWashington, DC_______________________Canadian MarketsCalgary ABEdmonton ABHalifax NSMontreal QCSaskatoon SKSt. Johns NLToronto ONVancouver BCWinnipeg MBLine Card Link(Required) Territory MapMax. file size: 50 MB.Company Description(Required)Please select all industries that applies to your company(Required) Automotive Commercial Horticulture Landscape NEMRA Municipal/DOT/Utility Petroleum Residential Showroom Other Other:(Required) How many years has your company been in the industry? 3 years or less 3-5 years 5-10 years 10+ years How many employees do you have?(Required)Less than 1010 - 40More than 40Please select total for all officesCompany LogoAccepted file types: png, jpg, Max. file size: 1 MB.A company logo can also be added later.Agency Primary Contact InformationName(Required) First Last Email(Required) Phone(Required)What is most valuable to you with your AAILA membership? Webinars Agency Principal Networking Networking/Community Professional Development Other Other:(Required) How did you you hear about us? Social Media Event/Networking Function Web Search Industry Colleague Other Other:(Required) Additional Offices Market Office Lead Phone Actions Edit Delete There are no Additional Offices. Add Office Maximum number of additional offices reached. Δ 2024 Annual Dues Less than 10 employees: $90010-40 employees: $1400More than 40 employees: $1900 Need help with this form? info@lightingagents.org
