Member - BIA Hawaii, HI

Thank you for your interest in becoming a BIA-Hawaii member. Please note that it may take 2-4 weeks for your application to be processed and reviewed for approval. *** If your company is already a BIA-Hawaii member, please call our office at 847-4666 to discuss the option to be added as an Affiliate. ***

Business Information

Company Name: *

Leave Blank:

Phone: *

Website:

Email: *

Directory Category: *

Comments / Questions:

Developer Type:

GET (State) Identification No.: *

Federal Identification No.: *

Annual Gross Revenue (if applying as a Builder):

Annual Gross Revenue (if applying as a Supplier):

License Number (if no license enter N/A): *

Name of member company referred by:

What made you want to become a BIA-Hawaii member?: *

Physical Address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Mailing Address

Same as physical address

Line 1: *

Line 2:

City: *

State: *

Postal Code: *

Country: *

Primary Contact Information

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Billing Contact Information

Same as Primary Contact

First Name: *

Last Name: *

Title: *

Phone: *

Cell Phone:

Fax:

Email: *

Contact Preference:

Email Phone

Address

Same as Member Address

Line 1: *

Line 2

City: *

State: *

Postal Code: *

Country: *

Membership Options

Membership Package: *

Builder/Developer/Contractor/Subcontractor: See fee schedule to determine the fee and enter it below.
Supplier: See fee schedule to determine the fee and enter it below.
Associate: See fee schedule to determine the fee and enter it below.
If using fee schedule, enter fee here:

Payment Option:

Charge my credit or debit card

Print Application

Title

Title

Member Application

Mailing Address

Address

Address