Member

Step 1:

Member Info

Company Name * required

Please add your company name.

Phone * required

Please add your company phone number.

Website * required

Please add your company website.

Email * required

Please add a valid email.

Physical Address

Address line 1 * required

Please add your address.

Address line 2

Country * required

Please add your country.

City * required

Please add your City.

State * required

Please add your State.

Postal Code * required

Please add your Postal Code.

Mailing Address

Same as physical address

Address line 1

Address line 2

Country

City

State

Postal Code

Social Network Addresses

Facebook

Step 3:

Primary Contact

First Name * required

Please add your first name.

Last Name * required

Please add your last name.

Title

Phone * required

Please add your phone number.

Cell Phone

Fax

Email * required

Please add a valid email.

Contact Preference

Phone

Address

Same as Address in Step 1

Address line 1 * required

Please add your address.

Address line 2

Country * required

Please add your country.

City * required

Please add your City.

State * required

Please add your State.

Postal Code * required

Please add your Postal Code.

Create Account

Password * required

Please add your login password.

Step 4:

Billing Contact

Same as Primary Contact

First Name * required

Please add your first name.

Last Name * required

Please add your last name.

Title

Phone * required

Please add your phone number.

Cell Phone

Fax

Email * required

Please add a valid email.

Contact Preference

Phone

Address

Address line 1 * required

Please add your address.

Address line 2

Country * required

Please add your country.

City * required

Please add your City.

State * required

Please add your State.

Postal Code * required

Please add your Postal Code.

Create Account

Password * required

Please add your login password.

Step 5:

Membership Package

Please select a Membership Package

Gold Membership $ 3,000

Includes: Membership for all company employees with access to “Member Login” on website to update company and employee information; add events to the SENEDIA website; and post company employment opportunities. Special invitation to SENEDIA’s Annual Meeting and Membership Appreciation Event. Head table seating and exclusive access to speakers at SENEDIA events. Complimentary registration for a team of four to the annual golf tournament.

Corporate Membership $ 1,000

Individual Membership $ 500

For people without a company affiliation, this affords a single person membership status. Access to “Member Login” on website to update personal information. Invitation to SENEDIA’s Annual Meeting and Membership Appreciation Event.

Comments/Questions

Payment Option

Bill Me

Charge my credit or debit card

Please complete the Captcha

Back Next Submit Application Print Application

Member Application

Step 1:

Member Info

Physical Address

Mailing Address

Social Network Addresses

Step 2:

Additional Info

Step 3:

Primary Contact

Address

Create Account

Step 4:

Billing Contact

Address

Create Account

Step 5:

Membership Package

Payment Option