ESTA Application for Membership

Application Fee and Dues

The application for membership fee is $500, payable to Electronic Security & Technology Association, which will be applied to the first quarter dues. If application is not accepted, fee will be refunded in full. Association dues are $500 per quarter, payable in advance.

Acknowledgement of ESTA By-Laws and Code of Ethics:

I, the Applicant/Owner, understand that prior to being accepted for membership, I am signing this Acknowledgement of ESTA By-Laws form by submitting the below form.

  • I accept on behalf of myself and my company all terms of the ESTA By-Laws, as amended on March 21, 2009, and in particular Article XIV (Non-Disclosure and Non-Use)
  • I also acknowledge and accept the ESTA Code of Ethics.
  • I agree to keep all information shared by members in the strictest confidence and understand that a non-disclosure form must be signed at each meeting.

 YOUR INFORMATION:
Information below marked with * are required.
Company*: 
Applicant/Owner*: 
Title: 
E-mail*: 
Day Phone* (w/area code): 
Cell Phone (w/area code): 
Fax (w/area code): 
Mailing Address: 
City: 
State: 
Zip: 
Company Website: 
Total Company Revenue  
(Past Fiscal Year): 

  AREAS OF BUSINESS (Check All That Apply):
       Residential Security
       Commercial Security
       Government/Institutional
       Commercial Fire
       Video Surveillance/CCTV
       Access Control
       Home Automation
       Telephone Systems
       Other, Please explain in box below:
                          
  Monitoring (please check all that apply):
       U.L. Central Station
       non-U.L. Central Station
       No Central Station
 
        Number of Monitored Accounts:

        Geographic Area Served (State, Counties or Zip Codes:
                          


 COMMENTS / ADDITIONAL INFO:



 
 
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