Please wait while we load your page...

affiliate Join

Garden State ASHI

Affiliate Application Form

Are you sure you want to Join? If your have already joined, and your intent is to register for an event/session/class, please login first, then visit the Calendar, and signup there. Otherwise, here are the steps:

Step 1. Fill out the form below to create an account.
Step 2. After you successfully create an account, you will then need to login to complete and maintain your Profile, and pay any applicable dues or fees to complete the application process.
For a frustration-free experience, complete all required fields below.


1. Be introduced at every meeting, feel free to give a public announcement/update about services/products offered.

2. Reduced Display Table at BOTH Spring and Fall seminars and introduced at the podium for each. Only $50 each seminar, includes dinner for one company representative!

3. Posting of bio/logo/photo and website link on our website.

4. Free admission to EVERY meeting (4 per year), including dinner, for one company representative.

Additional representatives are welcome at a cost of $ 50.00/each/meeting.

5. Use of our general membership mailing lists for advertising purposes!

AFFILIATE dues are NOW ONLY $250.00 for 2023-2024.  

I understand and accept that, as an AFFILIATE MEMBER, I am not a member of ASHI, Garden State ASHI, or any other ASHI special interest group, and as such, cannot vote or hold office, and cannot use the ASHI logo in any manner. I will benefit from access to the chapter’s educational programs and materials, along with other programs and services as approved and offered by the chapter. While I am not considered to be a member of the chapter, I can identify my AFFILIATE membership on stationary, business cards, brochures and other promotional materials. USE OF THE ASHI LOGO IS NOT PERMITTED.I have read, fully understand and accept all statements in this application. I hereby certify that all my statements are correct. I fully understand that AFFILIATE membership may be revoked for any violation regarding the use of the ASHI logo or any violation of the chapter’s bylaws governing AFFILIATE membership, by a 2/3rds vote of the Board of Directors of this chapter. I also affirm that I am authorized to make this contract on behalf of the company I represent.

Email Address
Cell Number
State / Province
First Name
Last Name
Only letters (lower and upper case), numbers, underscores allowed! Username must be 5 and 20 characters in length.
Password must contain at least one lower case letter, one upper case letter, one number, and at least one special character! Password must be between 10 and 20 characters in length.

  Opt-In to Text Messaging

Opt-In to our SMS text messages. You can always opt-out later via My Profile. Not required, but recommended because we use this feature to maintain attendance records and deliver important information.