APPLICATION FOR MEMBERSHIP VERMONT ASSOCIATION OF PROFESSIONAL HOME INSPECTORS Please Check One: ** Regular Membership : $150.00/yr. Affiliate Membership (business other than home inspecting): $100.00/yr. Student/Associate Membership (completing qualifications for membership): $75.00 Retired Membership (was a regular member previously): $25.00/yr. Name* Company Name* Address* Street Address Address Line 2 City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Office Phone*Home Phone*Cell Phone*Email* Enter Email Confirm Email Number of Years as a Home Inspector: **Less than a month1-6 months1-3 years3-6 years6-10 years10-15 yearsOver 15 YearsPlease Check One: ** Full-Time Part-Time Errors & Omission Insurance: ** Yes No Other Affiliations: **ASHI, NAHI, etc. Other Certifications: *By submitting this form and if accepted for membership you agree that you will familiarize yourself with and abide by the Bylaws of the Vermont Association of Professional Home Inspectors. Further, you understand that membership dues are not deductible as charitable contributions, but may be deductible as an ordinary and necessary business expense, subject to restrictions imposed as a result of association lobbying activities. By submitting this form you agree that all information contained herein is true and correct to the best of your knowledge.