Representative Membership Form

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ERA Representative Membership Form

Company Information

Company Name *

Contact Name *

Company Description *

Contact Email Address *

Phone Number

Upload Company Logo

Drag & Drop Files, Choose Files to Upload

Address *

Address Line 1

City

State / Province / Region

Postal Code

Country

Website / URL

Number of Employees

ERA Chapters/Territories Your Firm Covers: *

APAC (Asia Pacific)
ARIZONA — (Main office located in: Arizona; New Mexico)
CANADA — (Main office located in: Canada)
CAROLINAS — (Main office located in: North Carolina, South Carolina)
CHESAPEAKE — (Main office located in: Delaware, Maryland, Virginia, West Virginia)
CHICAGOLAND-WISCONSIN — (Main office located in: Illinois, Wisconsin)
EMPIRE STATE — (Main office located in: Upstate New York)
EMEA (Main office located in: Europe, Middle East, Africa)
FLORIDA — (Main office located in: Florida)
HEART OF AMERICA — (Main office located in: Kansas, Nebraska)
INDIANA/KENTUCKY — (Main office located in:
MEXICO — (Main office located in: Mexico)
MICHIGAN — (Main office located in: Michigan)
MID-LANTIC — (Main office located in: Eastern Pennsylvania, Southern NJ)
MINNESOTA — (Main office located in: Minnesota, South Dakota, North Dakota)
NEW ENGLAND — (Main office located in: Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island, Vermont)
NEW YORK METRO — (Main office located in: Metro New York, Northern New Jersey)
NORTHERN CALIFORNIA — (Main office located in: Northern California, Nevada)
OHIO — (Main office located in: Ohio)
PACIFIC-NORTHWEST — (Main office located in: Washington, Oregon, Idaho, Montana)
ROCKY MOUNTAIN — (Main office located in: Colorado, Montana, Wyoming)
SOUTHEAST — (Main office located in: Alabama, Georgia, Mississippi, Tennessee)
SOUTH AMERICA — (Main office located in: South America)
SOUTHERN CALIFORNIA — (Main office located in: San Diego, Southern California, Hawaii, Nevada)
SOUTHWEST — (Main office located in: Arkansas, Louisiana, Texas)
SPIRIT OF ST. LOUIS — (Main office located in: Iowa, Missouri)

Additional Facilities *

Application Engineering
Collection and Credit
Computer Mail and Reports
Demo Room
Demo Van
Distribution
Service Department
Warehouse

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
Consumer Video
Contract Mfg
Data Acquis and Control Sys
Discrete Devices
Electronic Security
Interconnect
LAN Products
Land Mobile Radio
Law Enforcement
Marine
Mfg Svcs
Microwave Comm Systems
Microwave IC
Multimedia and Graphics
Passive Components
PC Fabrication
Personal Communication
Personal Computers and Video games
Personal Entertainment
Power Sources and Mgmt
Radio Datacom
Satellite
Sensors
Small Office Home Office
Sound
Specialized Instr
Telecomm
Telephone Equipment
Test and Measurement
Transmission Lines
Wireless PCS

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
Distributor/Wholesalers
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)

ERA Membership Fee

How many Full-time employees? (National dues) *

1 – 3 - $450.00
4 – 9 - $650.00
10+ - $1,250.00

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+ - $1,250.00

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 - $1,250.00
11 - $1,250.00
12 - $1,250.00
13 - $1,250.00
14+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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 - $1,250.00
11 - $1,250.00
12 - $1,250.00
13 - $1,250.00
14+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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 - $1,250.00
11 - $1,250.00
12 - $1,250.00
13 - $1,250.00
14+ - $1,250.00

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+ - $1,250.00

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 - $1,250.00
11 - $1,250.00
12 - $1,250.00
13 - $1,250.00
14+ - $1,250.00

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+ - $1,250.00

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 - $1,250.00
11 - $1,250.00
12 - $1,250.00
13 - $1,250.00
14+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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+ - $1,250.00

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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Your Total ERA Membership Fee:

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