2006 DIA Membership Application

Print this application and mail to: Dive Industry Association, Inc. 2202 Lakewind Lane League City, Texas 77573-5795
2008 MEMBERSHIP APPLICATION
Company Name:
		Proprietorship		Partnership		Corporation
Years in business: ..
Contact Person:					Date of Birth:
Contact Person's Position:					Years with Company:

Business Address:
City:						State:	Zip:
Business Phone:				Fax:
Toll Free Phone:			Toll Free Fax:

Home Phone:				Cell:
E-mail Address for directories:

E-mail Address for DIA correspondence:
Website (URL)
Trade Directory by-line (1-2 lines only):
DEMA Member?	No Yes Number: _________________ Voting Delegate: ________________________
Category - Industry Business - (Choose One) $100 Annual Membership Dues
Manufacturer Distributor Retail Center Charter Boat Dive Club
Service Provider Industry Media Trade Association Training Association
Service Organization Trade Show Organizer Training Facility Travel Business
Category - Individual - $50 Annual Membership Dues
Sales Representative Professional Educator Industry Professional
Payment Method:
Check (payable to Dive Industry Association, Inc.) $ _________ Check # __________
If paying by Credit Card, please fill out Type: American Express MasterCard Visa
Credit Card #:					Expiration Date:
Card Holder's Name:					Signature:
Referred by:
*DIA retains the right to re-classify members according to our membership standards.
Mail to:	Dive Industry Association, Inc. 2202 Lakewind Lane League City, Texas 77573-5795
Fax: (281) 554-8050 .......... eMail: gene@diveindustry.net .......Web: www.diveindustry.net