Membership Renewal 2024-2025 Please enable JavaScript in your browser to complete this form.Name *FirstMiddleLastAddress *Address Line 1Address Line 2CityAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingStateZip CodePhone *Cell Phone *Email *Company Name *Website / URLPick your ASHI Status - MUST SELECT ONE: *ASHI Certified Inspector (ACI)ASHI Inspector/AssociateEducational Affiliate (Non-ASHI)ASHI Membership Number *REQUIRED FOR ASHI MEMBERS AND WILL BE VERIFIED. PICK NON-ASHI ABOVE IF YOU DO NOT HAVE A NATIONAL ASHI MEMBER NUMBERMonth Joining - ASHI Member *April - Full YearMayJuneJulyAugustSeptemberOctoberNovemberDecemberJanuaryFebruaryMarchMonth Joining - NON-ASHI Member *April - Full YearMayJuneJulyAugustSeptemberOctoberNovemberDecemberJanuaryFebruaryMarchNY COUNTY Service Area *WestchesterPutnamDutchessRocklandBronxBrooklynQueensManhattanStaten IslandNassauSuffolkNONECT COUNTY Service Area *Lower FairfieldUpper FairfieldNew HavenLitchfieldHartfordNONENJ COUNTY Service Area *BergenPassaicMorrisEssexHudsonUnionMiddlesexNONEPlease Select ALL the States You are Licensed inNew YorkConnecticutNew JerseyNY License #CT License #NJ License #Total Amount$ 0.00Stripe Credit Card *CardName on CardWebsiteSubmit
