Membership Application

Instructions

For more information contact Jim Geier at jgeier@hia-li.org or call (631)-543-5355.

Select An Option

HIA-LI Business Membership

Start-Up Company $300 Annually

Non Profit $225 Annually

Talent Transition $100 Annually

Enter Contact Information

Prefix (i.e. Mr. Mrs. Dr.)

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameBusiness Name

Please select a valid membership option and fee item if exist

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