Membership Application Form

Instructions

Annual Membership: January 1^st – December 31^st.
Fees are not pro-rated and are subject to change without notice.
Category selection subject to final approval by RAiNA.

Select An Option

Component / Material Supplier / Master Distributor

$5,000.00 Annually

Testing Agency / Code Body

$2,000.00 Annually

Associate

$1,000.00 Annually

Industry Professional

$500.00 Annually

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist

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