Application.  Please fill out application in its entirety.  Upon approval of your application, a letter approving your membership and invoice for dues will be mailed to you, and you can start attending meetings at the member price.  Once payment is received, you will receive a Certificate of Membership.  Thank you! 

Person Applying for Membership *
Designated Voting Representative
Company Name *
Title or Position
Street Address *
City *
Zip *
State *
Phone *
Fax
Your Email Address *
Years in our Industry *
Identify the owners/partners/officers of your company and their titles *
Year the company was established *
What type of business organization is your company? *
 Sole Proprietor
 Partnership
 Corporation
Is your company a franchisee?
 Yes
 No
How many employees? (include active owners/managers)
In which geographic areas do you work? (check all that apply) *
 Local
 State
 Regional
 National
 International
If International -- What countries?
Indicate the services your firm offers (check all that apply) *
 Executive / Retained Search
 Contingency Recruiting
 Applicant Paid Fee Placements
 Temporary Help
 Payrolling
 Leasing
 Testing
 Outplacement
 Consulting
Other(s)?
In what industries/areas do you specialize? *
What is your company's total number of offices? *
Name(s) of Arizona cities in which you have offices *
Are you a member of other industry associations? *
 Yes
 No
If so, please name
Are you a member of a network(s)? *
 Yes
 No
If so, please name
Are you interested in doing split business with other members?
 Yes
 No
Would you be willing to serve on an ASPA committee or the Board of Directors?
 Yes
 No
If yes, please select all that would interest you
 Board
 Membership
 Governmental Affairs
 Ethics
 Program
 Education / Certification
 Audit
Do you know of any information which would indicate that you or your company would not be evaluated as an ethical and professional business person or organization? *
 Yes
 No
If yes, explain
Who suggested you join ASPA?
Email addresses of others who may be interested
Please type the letters and numbers shown in the image.
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