Affiliate Membership Application

Instructions

Please complete the form below to apply for Affiliate Membership with TIGAR. This form is to be completed by the primary representative. Your membership allows for TWO representatives.

Annual membership is prorated on a monthly basis based on the yearly fee of $155.

Additional members can be added for $50 per year (not prorated).

Select Your Option(s)

Affiliate $155 Annually

Affiliate

Enter Contact Information

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

First Name

Last Name

Suffix (i.e Jr. Sr. III)

Designations

E-mail

Family NameOffice Name

Please select a valid membership option and fee item if exist