BIA Membership Application

Organization *

Address Line 1 *

Address Line 2

City *

State *

Enter required value

Postal Code *

Company size *

Please list the number of full time employees for New Hampshire.

Annual revenue *

Please choose from one of the ranges below.

Enter required value $1 million $10 million or less $100 million or less Over $100 million

Primary contact first and last name *

Primary contact title *

Primary contact email address *

Primary contact phone number *

How did you hear about BIA membership

News release

Colleague

Email

Other or direct referral

Please complete the contact information for a direct referral or other.

Areas of interest?

Public Policy and Advocacy

Policy Committees and Volunteer Opportunities

Events and Networking