You can use this logo, by simply sending us information about yourself, and by agreeing to meet the Licensing Regulations for New York State. This way, you will benefit from additional Professional Affiliations and you will not violate our guidelines if you are not qualified to use this logo. This Association Logo and its affiliation can be withdrawn by the Association Committee. All decisions of the committee are final. There is no fee for beloging to this New York Affiliation.

Print this entire form, and as of 1-1-06, unless there is an extension, you will be required to send in a copy of your Home Inspector License. In the event you do not qualify, you are restricted and prohibited from using this logo or listing any affiliation to NEW YORK INSPECTORS ASSOCIATION or NEW YORK INSPECTORS ASSOCIATION. COM.
Name_________________________________________ Phone_____________________________
Firm Name_____________________________________ Fax_______________________________
Address__________________________________________________________________________
Town/City______________________________ State_________ Zip Code_____________________
WEB SITE___________________________________ E-MAIL_______________________________
I agree to only use this association and logo as long s I am permitted to by the Association Committee. You must provide proof of a License to continue to use this logo after 1-1-06 unless, New York State extends the licensing regulations. I agree to this as a voluntary condition of permission to use the logo and associated web site as an affiliate member of NEW YORK INSPECTORS ASSOCIATION and NEW YORK INSPECTORS ASSOCIATION . COM
SIGNED_________________________________________________ DATE_____________________
FAX THIS ENTIRE FORM TO: 631-563-7719. YOU WILL RECEIVE E-MAIL CONFIRMATION UPON RECEIPT.