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Membership Types:
1 Year
2 Year
3 Year

Active Member

$125.00

$235.00

$300.00

Associate Member

$ 75.00

$135.00

$180.00
*Sponsored Employee

Sustaining Member

$ 25.00

$ 45.00

$ 60.00
*Sponsored Certified Security Guard

Affiliate Member

$150.00

$270.00

$360.00
*Sponsored Service Provider/Vendor
*Denotes Active Member must sponsor

M.I.S.A. Membership Application

Name:

Company Name:

Address:
City:

State:
Zip Code:
Phone:
Fax:
E-Mail:
Web Site:
Agency License #
State of Issue:
I.D. Card #
Exp. Date of License/Card:
List Additional States Licensed:
Membership Type:
(Select from above list)
Membership Fee:

____ Add me to the MISA email group.
____ I am interested in a committee position.

Fill in the necessary information, sign and print this form, include check or money order payable to MISA
and mail to:

M.I.S.A
P.O. Box 331
Kingsville, Md 21087

If you want to pay by credit card, please note that on the application. You will be contacted upon receipt of the signed application.


_____________________________________________ Signature

_____________Date


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