Supporting Partner Membership Application

To submit an NYSSIU application, complete this webform click “Send form” and pay your dues online:

Your Name (required)*
First Last
Company Name*
Company Address*
Your Email (required)*
Work Phone*
Cell Phone*
Job Title*
Company URL*
Description of Expertise/Services Provided*
E-Signature*
Membership Type*
Today's Date*
MM slash DD slash YYYY
*
I have read the above criteria for NYSSIU membership and warrant that I qualify for supporting partner membership.
*
I/my company provides expertise or services to insurers, prosecutors or law enforcement.
*
I understand this application is subject to acceptance by the Board of Directors and further that if my employment duties change so as to fall outside the requirements for membership, my membership in the organization shall terminate.
*
I hereby make application for membership in the New York State Chapter of Special Investigation Units, Inc., in accordance with its Constitution and By-Laws and agree to be bound thereby.
Credit Card*