Professionals Membership Application
Full Member
$
150.00
Any person representing a business, firm, or corporation.
Company
$
300.00
Any business, firm, or corporation.
Student
$
75.00
Currently enrolled in an educational institution.
Select Your Payment Cycle
(2) YEAR Full Member
(1) Year Full Member
Select Your Payment Cycle
(2) YEAR Company
(1) YEAR Company
Select Your Payment Cycle
(2) Year Student
(1) Year Student
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Professionals Membership Application
*
Member Photo
Done
(Use Cropper to set image and
use mouse scroller for zoom image.)
Done
(Use Cropper to set image and use mouse scroller for zoom image.)
Drop file here or click to select.
* First Name
* Last Name
* Job/Position Title
* Email Address
* Confirm Email Address
* Phone Number
Facebook Link
paste full link - including https://
LinkedIn Profile Link
paste full link - including https://
Twitter Profile Link
paste full link - including https://
* Password
Strength: Very Weak
* Confirm Password
Company Information
* Company Name
*
Company Logo
Drop file here or click to select.
* Company Phone
* Company Size
* About the Company
* Company Website
please enter http:// or https://
* Company Email
for general inquiries, not specific to you
* Company Address 1
Company Address 2
* Company City
* Company State
* Company Zip Code
Company Photos
Drop file here or click to select.
displayed on company profile
*
May the above contact information be listed on the LIHA website?
Yes
No
*
May your e-mail be used to send you updates regarding the LIHA?
Yes
No
If you are a hotelier, restaurant, destination or have event space, would you consider hosting an LIHA event?
Yes
No
*
Would you like to be considered for an LIHA General Board Member position?
Yes
No
Select Your Payment Gateway
Paypal
How you want to pay?
Auto Debit Payment
Manual Payment
Payment Summary
Your currently selected plan :
, Plan Amount :
Coupon Discount Amount :
, Final Payable Amount:
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