Dues Renewal 2017

Membership Renewal 2017
Contact Information:
Name:  
Company Name (as it appears on the invoice):  
Address:  
City:  
State/Province:  
Zip/Postal Code:  
Office Phone:  
EMail:  

Please select your dues level according to total number of employees.
Annual YBAA Membership Renewal
Annual YBAA Membership Renewal for 1 Broker Firm=$345.00
Annual YBAA Membership Renewal for 2 to 3 Broker Firm = $425.00
Annual YBAA Membership Renewal for 4 to 6 Broker Firm = $560.00
Annual YBAA Membership Renewal for 7 to 11 Broker Firm = $715.00
Annual YBAA Membership Renewal for 12 or more Broker Firm =$855.00*
*Add $40.00 for each additional broker over 12

Or
Affiliate Membership Renewal $490.00

Membership Type:  
Add $40.00 for each additional broker over 12  
The authorized total to be charged to my credit card :  

BRANCH annual renewal fee ($50.00 per branch) for additional locations only. If you only have one company location a branch fee is not owed. Please list branch location(s):
Example:
ABC Company
111 Distribution Lane
Annapolis, MD 21403
Branch Location(s):
Please total up your number of branch locations
x 50 =
Click here for fee chart.
Questions? Please call YBAA (410) 940-6345.
   - denotes required fields