ASSOCIATE MEMBERSHIP APPLICATION

MAILING INFORMATION:
FIRM
NAME_______________________________________________________________________
MAILING
ADDRESS___________________________________________________________________
TELEPHONE NUMBER______________________________FAX_______________________

E-MAIL___________________________________________________________________

PRESIDENT OR  CEO______________________________________________________
YOUR RELATIONSHIP TO THE COMPANY________________________________________

COMPANY  DATA:
PLEASE ENTER THE YEAR THAT YOUR COMPANY ENTERED INTO THE BUSINESS
___________________________________________

OTHER ASSOCIATIONS :
IF YOUR COMPANY BELONGS TO OTHER ASSOCIATIONS PLEASE INDICATE THEIR NAME BELOW
___________________________________________________________________________
___________________________________________________________________________
___________________________________________________________________________

DELAWARE STATE SECURITY   FOR  (MONITORING COMPANIES)
LICENSE_____________________________________________________
DELAWARE STATE FIRE
LICENSE_____________________________________________________
__________________________________________________________________________
This application must be accompanied by a check made out to the Delaware Alarm
Association for $100.00. This application fee will be refunded in the event this application is denied.
The dues are from January 1st to December 31st  and are not prorated.

Our firm applies for AN ASSOCIATE  MEMBERSHIP in the Delaware Alarm Association. 
All information contained in the application is true and accurate and the
undersigned acknowledges that false information can
result in denial of this application.  The undersigned  does agree to the
prompt payment of all Association dues when due and to abide by and subscribe
to the by-laws and the Delaware Alarm Association Code of Ethics.

SIGNED
BY:__________________________________________TITLE____________________________
___

THIS ______________DATE OF___________________20______


DELAWARE ALARM ASSOCIATION SPONSOR

NAME:_______________________________________________TITLE_____________________
DATE_____________

MAILING ADDRESS: Delaware Alarm Association    P.O. Box 255   Hockessin Delaware 19707
Meetings are the First Wednesday of each month from 6:00 to 8:30 pm.
Meeting Address: Associated Builders & Contractors class room  31 Blevins Drive Suite B
New Castle Delaware 19720
For additional information please call Dan Delcollo 302-994-5400