This page may not work correctly in your current browser, Internet Explorer. We recommend changing to a more modern browser before viewing this page. We recommend
Chrome
,
Firefox
,
Safari
, or
Edge
.
Membership Application
Personal Information
First Name:
Middle/Initial:
Last Name:
Company:
Gender:
Female
Male
Birth Date:
/
/
Home Address Line 1:
Home Address Line 2:
City:
State:
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
American Samoa
Federated States of Micronesia
Guam
Marshall Islands
Northern Mariana Islands
Palau
Puerto Rico
U.S. Minor Outlying Islands
Virgin Islands
Armed Forces Americas
Armed Forces Europe, the Middle East, an
Armed Forces Pacific
Alberta
British Columbia
Manitoba
New Brunswick
Newfoundland and Labrador
Nova Scotia
Northwest Territories
Nunavut Territory
Ontario
Prince Edward Island
Quebec
Saskatchewan
Yukon Territory
Province (Foreign)
Zip Code:
-
Zip Suffix
Home Phone:
Fax:
Email:
Web Site:
Speciality (Choose 1 or more):
Bed Room/Dining Room
Occasional
Occasional Storage
Upholstery
Motion Upholstery
Leather Upholstery
Seating - Occasional
Accessories
Lighting
Casual Outdoor
Home Office
Entertainment Furniture
Juvenile - Youth Furniture
Rugs and/or Floor Covering
Wall Decor
Wicker Rattan
RTA
Textiles
Contract Office and/or Residential
Retail Display Furniture
This is a Referral Listing?:
Yes
No
Membership:
Affiliate - $140
Associate - $140
Sustaining - $600
Educator - $100
Professional Designer - $225
Emerging Professional Designer - $140
Multiple Member Professional Design Firm Membership- $125
Furniture Maker/Designer $180
Professional Designer Retired - $50
Student - $35
The membership you have selected will automatically renew.
Add a donation of::
Date Graduated: