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Representative Membership Form
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Representative Membership Form
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ERA Representative Membership Form
Company Information
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Company Name
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Company Description
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Contact Name
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Contact Email Address
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Phone Number
Address
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Address Line 1
City
State / Province / Region
Postal Code
— Select country —
Afghanistan
Albania
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American Samoa
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Angola
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Antarctica
Antigua and Barbuda
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Austria
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Bonaire, Saint Eustatius and Saba
Bosnia and Herzegovina
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Cook Islands
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Cyprus
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Côte d'Ivoire
Denmark
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Ecuador
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Guinea
Guinea-Bissau
Guyana
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Honduras
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India
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Iran (Islamic Republic of)
Iraq
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Israel
Italy
Jamaica
Japan
Jersey
Jordan
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Libya
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Mali
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Mexico
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Moldova (Republic of)
Monaco
Mongolia
Montenegro
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Morocco
Mozambique
Myanmar
Namibia
Nauru
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Netherlands
New Caledonia
New Zealand
Nicaragua
Niger
Nigeria
Niue
Norfolk Island
North Macedonia (Republic of)
Northern Mariana Islands
Norway
Oman
Pakistan
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Panama
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Paraguay
Peru
Philippines
Pitcairn
Poland
Portugal
Puerto Rico
Qatar
Romania
Russian Federation
Rwanda
Réunion
Saint Barthélemy
Saint Helena, Ascension and Tristan da Cunha
Saint Kitts and Nevis
Saint Lucia
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Saint Pierre and Miquelon
Saint Vincent and the Grenadines
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
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Singapore
Sint Maarten (Dutch part)
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
South Georgia and the South Sandwich Islands
South Sudan
Spain
Sri Lanka
Sudan
Suriname
Svalbard and Jan Mayen
Sweden
Switzerland
Syrian Arab Republic
Taiwan, Republic of China
Tajikistan
Tanzania (United Republic of)
Thailand
Timor-Leste
Togo
Tokelau
Tonga
Trinidad and Tobago
Tunisia
Turkmenistan
Turks and Caicos Islands
Tuvalu
Türkiye
Uganda
Ukraine
United Arab Emirates
United Kingdom of Great Britain and Northern Ireland
United States Minor Outlying Islands
United States of America
Uruguay
Uzbekistan
Vanuatu
Vatican City State
Venezuela (Bolivarian Republic of)
Vietnam
Virgin Islands (British)
Virgin Islands (U.S.)
Wallis and Futuna
Western Sahara
Yemen
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Zimbabwe
Åland Islands
Country
Website / URL
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Additional Information
Enter as much information as you can; for regions, products, etc… please separate each with a comma.
(ie: Avionics, Buying Groups, Contractor/Installer, Distributor/Wholesalers, End User, Government, Industrial/OEM, Medical, Military/Aerospace, Public Utilities)
Territories
*
APAC
Arizona
Canada
Carolinas
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Empire State
EMEA
Florida-Sunshine
Heart of America
Indiana/Kentucky
International Chapter
Keystone Mountain
Mexico
Michigan
Mid-Lantic
Minnesota
New England
New York
Northern California
Ohio
Pacific Northwest
Pioneer
Southeast
South America
Southern California
Southwest
Spirit of St. Louis
Products
*
Accessories
Active Components
ATE and Quality and Prod test
Audio and Visual
Automotive Elex
Avionic Comm
Capital Equipment
Cellular
Circuit Card Assembly
Components and Sub Assemblies
Computer Telecomm
Consumer Audio
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Contract Mfg
Data Acquis and Control Sys
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LAN Products
Land Mobile Radio
Law Enforcement
Marine
Mfg Svcs
Microwave Comm Systems
Microwave IC
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Passive Components
PC Fabrication
Personal Communication
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Personal Entertainment
Power Sources and Mgmt
Radio Datacom
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Sound
Specialized Instr
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Test and Measurement
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Wireless PCS
ERA Chapters
APAC
ARIZONA
CANADA
CAROLINAS
CHESAPEAKE
CHICAGOLAND-WISCONSIN
EMEA
EMPIRE STATE
FLORIDA-SUNSHINE
HEART OF AMERICA
INDIANA-KENTUCKY
MEXICO
MICHIGAN
MID-LANTIC
MINNESOTA
NEW ENGLAND
NEW YORK
NORTHERN CALIFORNIA
OHIO
PACIFIC NORTHWEST
Rocky Mountain
South America
SOUTHEAST
SOUTHERN CALIFORNIA
SOUTHWEST
SPIRIT OF ST. LOUIS
Additional Facilities
*
Application Engineering
Collection and Credit
Computer Mail and Reports
Demo Room
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Distribution
Service Department
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Product Groups
*
Communications
Components
Computer
Consumer Electronics
Electronic Systems Integration Group
Instrumentation and Sensors
Materials Assembly Production and Supply
RF Microwave and Wireless
Semiconductors
Customer Base
*
Avionics
Broadcast/Studio
Buying Groups
Contractor/Installer
Dealers in Mexico
Department Stores
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Distributors in Mexico
Distributors US Serving Mexico
Educational
End User
Government
Industrial/OEM
Institutions
Maquiladoras
Mass Merchandisers/Chains
Medical
Military/Aerospace
Public Utilities
Retailer/Dealer
Systems Integrators Mexico
Systems Integrators US Serving Mexico
Tele Op Companies
Value Added Reseller (VAR)
Continue
ERA Membership Fee
How many Full-time employees? (National dues)
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Arizona Chapter Dues
Price:
$125.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
ERA National Dues (Canada):
*
Annual Fee – $350.00
Canada Chapter Dues
Price:
$100.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
How many full-time employees? (National dues:)
*
1 – $450.00
2 – $450.00
3 – $450.00
4 – $650.00
5 – $650.00
6 – $650.00
7 – $650.00
8 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Carolinas Chapter Dues (1 Employee):
Price:
$50.00
Carolinas Chapter Dues (2 Employees):
Price:
$100.00
Carolinas Chapter Dues (3 Employees):
Price:
$150.00
Carolinas Chapter Dues (4 Employees):
Price:
$200.00
Carolinas Chapter Dues (5 Employees):
Price:
$250.00
Carolinas Chapter Dues (6 Employees):
Price:
$300.00
Carolinas Chapter Dues (7 Employees):
Price:
$350.00
Carolinas Chapter Dues (8-9 Employees):
Price:
$400.00
Carolinas Chapter Dues (10+ Employees):
Price:
$400.00
How many full-time employees? (ERA National Dues):
*
1 – $450.00
2 – $450.00
3 – $450.00
4 – $650.00
5 – $650.00
6 – $650.00
7 – $650.00
8 – $650.00
9 – $650.00
10 – $1,000.00
11 – $1,000.00
12 – $1,000.00
13 – $1,000.00
14+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
How many full-time employees? (ERA National dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Chicagoland-Wisconsin Chapter Dues: (1-3 Employees)
Price:
$150.00
Chicagoland-Wisconsin Chapter Dues: (4-9 Employees)
Price:
$250.00
Chicagoland-Wisconsin Chapter Dues: (10+ Employees)
Price:
$400.00
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Empire State Chapter Dues:
Price:
$100.00
How many full-time employees? (ERA National Dues):
*
1 – $450.00
2 – $450.00
3 – $450.00
4 – $650.00
5 – $650.00
6 – $650.00
7 – $650.00
8 – $650.00
9 – $650.00
10 – $1,000.00
11 – $1,000.00
12 – $1,000.00
13 – $1,000.00
14+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Florida Chapter Dues (1 Employee):
Price:
$65.00
Florida Chapter Dues (2 Employees):
Price:
$80.00
Florida Chapter Dues (3 Employees):
Price:
$95.00
Florida Chapter Dues (4 Employees):
Price:
$110.00
Florida Chapter Dues (5 Employees):
Price:
$125.00
Florida Chapter Dues (6 Employees):
Price:
$140.00
Florida Chapter Dues (7 Employees):
Price:
$155.00
Florida Chapter Dues (8 Employees):
Price:
$170.00
Florida Chapter Dues (9 Employees):
Price:
$185.00
Florida Chapter Dues (10 Employees):
Price:
$200.00
Florida Chapter Dues (11 Employees):
Price:
$215.00
Florida Chapter Dues (12 Employees):
Price:
$230.00
Florida Chapter Dues (13 Employees):
Price:
$245.00
Florida Chapter Dues (14 Employees):
Price:
$260.00
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Heart of America Chapter Dues:
Price:
$10.00
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Indiana/Kentucky Chapter Dues:
Price:
$130.00
EMEA Full Membership
*
Annual Fee – $350.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Mexico ERA – ERA National Membership
Price:
$350.00
Mexico ERA Chapter Dues
*
Price:
$100.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Michigan Chapter Dues:
Price:
$130.00
How many full-time employees? (ERA National):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Mid-Lantic Chapter Dues:
Price:
$100.00
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4-9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Minnesota Chapter Dues:
Price:
$100.00
How many full-time employees? (ERA National):
*
1 – $450.00
2 – $450.00
3 – $450.00
4 – $650.00
5 – $650.00
6 – $650.00
7 – $650.00
8 – $650.00
9 – $650.00
10 – $1,000.00
11 – $1,000.00
12 – $1,000.00
13 – $1,000.00
14+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
New England Chapter Dues (1 Employee):
Price:
$150.00
New England Chapter Dues (2 Employees):
Price:
$180.00
New England Chapter Dues (3 Employees):
Price:
$210.00
New England Chapter Dues (4 Employees):
Price:
$240.00
New England Chapter Dues (5 Employees):
Price:
$270.00
New England Chapter Dues (6 Employees):
Price:
$300.00
New England Chapter Dues (7 Employees):
Price:
$330.00
New England Chapter Dues (8 Employees):
Price:
$360.00
New England Chapter Dues (9 Employees):
Price:
$390.00
New England Chapter Dues (10 Employees):
Price:
$420.00
New England Chapter Dues (11 Employees):
Price:
$420.00
New England Chapter Dues (12 Employees):
Price:
$480.00
New England Chapter Dues (13 Employees):
Price:
$510.00
New England Chapter Dues (14 Employees):
Price:
$540.00
How many full-time employees? (ERA National Dues):
*
1 – 2 – $450.00
3 – $450.00
4-9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
New York Metro Chapter Dues: (1-2 employees)
Price:
$50.00
New York Metro Chapter Dues: (3 employees)
Price:
$75.00
New York Metro Chapter Dues: (4-9 employees)
Price:
$100.00
New York Metro Chapter Dues: (10+ employees)
Price:
$100.00
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – $650.00
5 – $650.00
6 – $650.00
7 – $650.00
8 – $650.00
9 – $650.00
10 – $1,000.00
11 – $1,000.00
12 – $1,000.00
13 – $1,000.00
14+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Northern California Chapter Dues:
Price:
$150.00
Northern California Chapter Dues:
Price:
$150.00
Northern California Chapter Dues:
Price:
$155.00
Northern California Chapter Dues:
Price:
$160.00
Northern California Chapter Dues:
Price:
$165.00
Northern California Chapter Dues:
Price:
$170.00
Northern California Chapter Dues:
Price:
$175.00
Northern California Chapter Dues:
Price:
$180.00
Northern California Chapter Dues:
Price:
$185.00
Northern California Chapter Dues:
Price:
$190.00
Northern California Chapter Dues:
Price:
$195.00
Northern California Chapter Dues:
Price:
$200.00
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Ohio Chapter Dues:
Price:
$130.00
How many full-time employees? (ERA National Dues):
*
1 – $450.00
2 – $450.00
3 – $450.00
4 – $650.00
5 – $650.00
6 – $650.00
7 – $650.00
8 – $650.00
9 – $650.00
10 – $1,000.00
11 – $1,000.00
12 – $1,000.00
13 – $1,000.00
14+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Pacific Northwest Dues: (1 employee)
Price:
$80.00
Pacific Northwest Dues: (2 employees)
Price:
$90.00
Pacific Northwest Dues: (3 employees)
Price:
$100.00
Pacific Northwest Dues: (4 employees)
Price:
$110.00
Pacific Northwest Dues: (5 employees)
Price:
$120.00
Pacific Northwest Dues: (6 employees)
Price:
$130.00
Pacific Northwest Dues: (7 employees)
Price:
$140.00
Pacific Northwest Dues: (8 employees)
Price:
$150.00
Pacific Northwest Dues: (9 employees)
Price:
$160.00
Pacific Northwest Dues: (10 employees)
Price:
$170.00
Pacific Northwest Dues: (11 employees)
Price:
$180.00
Pacific Northwest Dues: (12 employees)
Price:
$190.00
Pacific Northwest Dues: (13 employees)
Price:
$200.00
Pacific Northwest Dues: (14 employees)
Price:
$210.00
How many full-time employees?
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
How many full-time employees?
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Rocky Mountain Chapter Dues:
Price:
$100.00
How many full-time employees? (ERA National Dues):
*
1 – $450.00
2 – $450.00
3 – $450.00
4-9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Southeast Chapter Dues: (1 Employee):
Price:
$35.00
Southeast Chapter Dues: (2 Employees):
Price:
$70.00
Southeast Chapter Dues: (3 Employees):
Price:
$100.00
Southeast Chapter Dues: (4-9 Employees):
Price:
$100.00
Southeast Chapter Dues: (10+ Employees):
Price:
$100.00
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Southern California Chapter Dues: (1-3 Employees):
Price:
$350.00
Southern California Chapter Dues: (4-9 Employees): (copy)
Price:
$350.00
Southern California Chapter Dues: (10+ Employees): (copy) (copy)
Price:
$350.00
How many full-time employees? (ERA National Dues):
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Southwest Chapter Dues (1-3 Employees):
Price:
$100.00
Southwest Chapter Dues (4-9 Employees): (copy)
Price:
$200.00
Southwest Chapter Dues (10+ Employees):
Price:
$300.00
How many full-time employees? (ERA National Dues)
*
1 – 3 – $450.00
4 – 9 – $650.00
10+ – $1,000.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
Spirit of St. Louis Chapter Dues:
Price:
$150.00
APAC (Asia – Pacific) Full ERA Membership
*
Annual Fee – $350.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
South America Chapter – Full ERA Membership
Price:
$350.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
EMEA Chapter – Europe; Middle East; Africa – Full ERA Membership
Price:
$350.00
For details and fee structure of our ERA Membership Fee, please visit by
clicking here
. Any other information request, please
contact us
.
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