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MEMBERSHIP APPLICATION

LLSSA Membership application

Primary Voting Representative
Complete information for the voting representative or company contact.
Person name*
Phone*
Address*
Street Address Address Line 2 City State ZIP Code
Email*
Fax Number
Notes
Membership Information
Membership*
Number of employees
Number of Locations
Month/Year Founded
License Endorsements
- Locksmith
- Security
- Limited Locksmith
- Door Hardware
- Bank Locking
- Detention Locking
- CCTV
- Household Fire
- Fire Sprinkler
- Fire Suppression
- Fire Extinguishers
- Hydrostatic Testing
- Pre-Engineered
- Kitchen Suppression
- Fire Alarm (non-required)
- Fire Alarm Owner
- Fire Alarm
Check all that apply.
Company Information
Company Name*
Phone*
Company Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email address to send the invoice for payment*
Website URL
Firm License #
What services do you offer?
- Access Control
- CCTV
- Central Vac
- Contract Monitoring
- FM Approved
- Guards
- Home Automation
- I Q Certified
- Local Burglary
- Local Fire
- Locksmith
- Modulation
- Monitoring Burglary
- Monitoring Fire
- Own A Central Station
- Proprietary Alarms
- Telephone Systems
- UL-Listed
- Other
Check all that apply.
Number of employees
Consent*
I have authority to complete the application for the company.
Fax Number