• Please provide the following contact information:

  First Name
  MI
  Last Name
  Title
  Company
  Street Address
  Address (cont.)
  City
  State/Province	(two letter abbreviation ONLY)
  Zip/Postal Code
  Work Phone
  Cell Phone
  FAX
  E-mail
  URL

Joining/Renewing Membership NY Metro ASHI^® as an:

• ASHI^® Member (all $175 4-1-2011 thru 3-31-2012)

            Certified Inspector

        Associate

        Associate, No Logo

•     ASHI^® Member Number    (Candidates leave "0")

• Non-ASHI^® Member  ($100)

        NY Metro Candidate (6 month limit)

NY License Number         CT License Number

NJ License Number         MA License Number

Only the information provided will be posted on the website!!!!

*Candidates are NOT listed on the website until they become ASHI^® Members

Please, hit "Submit Form" only Once.  Please WAIT for the Confirmation Page to appear.