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Membership Application

Company Name:

Contact:

Title:

Address:
 Include apt or suite

City:

State:

Zip + 4 :

Telephone:

Mobil Phone:

Fax:

Email:

Web Site:

Password for this site:

Confirm Password:

Year Established:    
No. of Employees:      NYS License #:

Principal or Corporate Officer:

Official Representative to the MBFAA:

 

Types of services your company offers (check all that apply)
(RED FIELDS REQUIRE YOU TO HAVE THE APPROPRIATE NYS LICENSE.
IF YOU DID NOT INCLUDE YOUR  NYS LICENSE # IN THE FIELD ABOVE,
WE WILL NOT LIST YOUR COMPANY IN THE SEARCH RESULTS FOR THE SERVICES REQUIRING A LICENSE.)
(Other services, like Locksmithing, may require a local license. Enter in the "Other" field.)

 
 

Burglar    Fire   CCTV  Access Control
System Integration Networking

 

Telephone SystemsIntercom Systems
Home Theater Audio Speakers and Paging

 

Energy Management Locksmithing Guard Services
Electrical Contractor  Vehicle Alarms

 

Subcontracting to other alarm companies
Alarm Equipment Distributor

 

Other supplier to trade Manufacturer   

 

Other (explain)

 

Are YOU a Central Station for:

Burglar Fire Audio Video Wholesale to the trade

Is YOUR company UL listed for:

Burglar Fire Central Station Alarms      

   
 

Areas where you do business (check ONLY that apply)

 
 

Manhattan Brooklyn Queens Bronx Staten Island
Nassau County Suffolk County

 
 

New Member     Former Membership
Year of former Membership:

 
 

MBFAA Dues: $299.95
 
Credit Cards Accepted
 
Checks/Money Orders Made out to MBFAA, New York

WE WILL INVOICE YOU AT THE ADDRESS YOU GAVE US