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Home > Membership > How to Join > Request Information
 
Request Information

To request more information on how to join AFSA and learn more about the benefits to your company, please complete the form below and submit.

* Must be completed

Membership Type:*
 
Salutation:
 
First Name:
  *
Nickname:
 
Middle Initial:
 
Last Name:
  *
Suffix:
  *
Job Title:
  *
Company:
  *
Address:
  *
City/State/Zip:
  *
Phone:
  *
Company Website:
 
My Company is a
(Select All that Apply)
*
 
      Auto Finance Company
      Card Issuer
      Consumer Credit provider
      Commercial Finance Company
      Mortgage Lender
      Consultant
      Consumer Bank
      Financial Services Industry Supplier
      State Consumer Finance Association
      Sales Finance Company (non-auto)
Other:
 
Does Your Company Operate in the US?
 
     Yes        No
Does Your Company Operate Outside of the U.S?
 
     Yes        No
Does your company or affiliated subsidiaries or parent company engage in payday lending?
 
     Yes        No
Does your company or affiliated subsidiaries or parent company engage in title loan lending?
 
     Yes        No
I am interested in:
 
      Membership Information
      Membership Appllication
      Dues Calculation Form (Active only)
      Committees
      Section/Divisions
      Conferences
      Legislative Priorities
Other:
 
Please contact me by :
 
     Phone  *
     Email   *
How did you hear about AFSA?
 
      Conference/Meetings
      Website
      Referral
      State Association
      Read About in Press
      Former Member
Other:
 
* Please type the characters you see:
    Thank you.
 
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