2018Allied Membership Application

2018Allied Membership Application

Allied membership is open to engineers, planners, landscape architects, sculptors, muralists, artists, and those in government, education,

journalism, and manufacturing industry, and other fields allied to architecture. Applicants cannot be eligible for Architect, International

Associate AIA or Associate AIA membership. Allied members may not use the initials “AIA” or the phrase “The American Institute of

Architects” alone or otherwise, nor the seal, symbol or insignia of This Chapter or the Institute, but may use the phrase, “Allied Member

of the AIA Orange County Chapter of the American Institute of Architects” to describe themselves.

Personal Information(Print your name clearly)

Mr. Mrs. Ms.First nameM.I.Last name

Home addressApartment number

CityStateZIPCountry

Home phone Home faxCell phone

Date of birth (Optional)Home e-mail

Company Information

Company name/acronymJob title

Company addressSuite/floor number

CityStateZIPCountry

Company phone Company faxCompany e-mailCompany Web address

Preferred Address (check one)

Mail (for print materials): Home OR Office

E-mail (for correspondence): Home OR Office

I do not wish to be listed in any membership list sold by the AIA to third parties.

Professional Information(Check the profession that you represent.)

Engineer
Publishing
Product Manufacturing
Real Estate
Planning
Consulting
Education
Landscape architecture / Landscape architecture
Interior design
Law firm
Construction Company
Art
Contracting
Technology
Other **______/ Are you a member of any of the following professional organizations?
GCBI LEED AP # ______
USGBC National Member (Company)
USGBC Local Member (Individual)
I was referred to join the AIA by (check only one):
Local chapter
State chapter
National advertisement
AIA member ______

**Description of Business/Services: ______

Membership Dues

Membership is based on a calendar year from January to December. New and reinstated member dues are prorated quarterly. Membership valid through December 2018.

Joining between
10/1/17–3/31/18 / Joining between
4/1/18 – 6/30/18 / Joining between
7/1/17 – 9/30/18
**$350.00 / $262.50 / $175.00
If you join in October, you receive membership through December 2018!

*** 15 months of membership for the price of a 12 month membership when joining in October 2017 / 14 months of membership when joining in November 2017 /

13 months of membership when joining in December 2017 ~ membership is valid through December 2018.

Method of Payment

Submit full payment of your local membership dues.Dues are not a tax-deductible donation but may be eligible as a business expense deduction. .

Check enclosed(payable to the American Institute of Architects, OC Chapter) Charge my:Visa MasterCard American Express

We will call you for your number

Card numberExpiration date

CardholderSignature

Please let us know who pays your professional AIA membership dues? (Please check one)

Firm/Company

Myself

Partial payment from Firm/Company

AIAOC Sponsor (Complementary Membership)

Return to:

American Institute of Architects

Orange Country Chapter

4100 Birch Street, Suite 300

Newport Beach, CA 92660

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