PIA VA/DC Membership Application
Select An Option
Retired Membership
$35 Annually
Associate Membership
$200 Annually
Smart Choice Agency Membership: Tier 1-2
$225 Annually
Smart Choice Agency Membership: Tier 3-12
$330 Annually
Agency Membership: Tier 1-2
$450 Annually
Company Membership
$650 Annually
Agency Membership: Tier 3-12
$660 Annually
Agency Membership: Tier 13-19
$1080 Annually
Agency Membership: Tier 20-30
$1255 Annually
Agency Membership: Tier 31+
$2500 Annually
Long Term Sponsor - Silver
$2500 Annually
Long Term Sponsor - Gold
$5000 Annually
Long Term Sponsor - Platinum
$7500 Annually
Long Term Sponsor - Diamond
$10000 Annually
Enter Contact Information
Prefix (i.e. Mr. Mrs. Dr.)
First Name
Last Name
Suffix (i.e Jr. Sr. III)
Designations
E-mail
Family Name
Business Name
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Please select a valid membership option and fee item if exist
