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SSIA Retailer Membership Application

 

SSIA retailer membership dues are $25 per year. To join, please fill out the form below and press the Register Now button. You will then be taken to another screen with payment options. You will receive an e-mail confirmation when your membership is activated.

Note: Your dues are deductible as an ordinary and necessary business expense, and are not deductible as a charitable contribution.


Login Information: For access to the members only section of our site. All fields required. You must provide a valid e-mail address in order to activate your membership.

 

Email:

Username:

Password:

Confirm Password:

 
Business Information: Required fields marked with *. Make sure your information is complete. We will use this to add you to our shop locator.
 

Full Name:*

Company:*

Web Site:

Address:*

City:*

State:*

Zip Code:*

Country:

Phone:*

Fax:

 

Anti-Spam Verification: Please enter the code below. It helps us keep spammers out.

 

Verification Code:

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Subscription:

(Newsletter subscription)


Payment Options


Payment Method:

Preview options that will be available on the next page.


  © 2005 Shoe Service Institute of

© 2010 Shoe Service Institute of America
305 Huntsman Ct. • Bel Air, MD 21015 • 410-569-3425 • fax: 410-569-8333 • webmaster@ssia.info