or complete the online form below. (For additional contacts, please submit this form and then complete it again.)Company Name(Required) Name(Required) First Last Title(Required) Type of Business(Required) Mailing Address(Required) Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email Recruited By Phone Number(Required)Fax Number# of Arkansas Employees(Required)NAICS#(Required) Associated Industries of Arkansas (AIA) is the industrial group of the State Chamber. An issue may arise of greater importance to the manufacturing sector than to general business, so AIA may pursue it. If your company’s NAICS code begins with a 2 or a 3, you will be identified as an AIA member and receive a complimentary membership in the State Chamber as well. If you are interested in serving on committees that deal with any of the following issues, please check:Committees Arkansas Small Business Council Health Unemployment Compensation Education Tax Workers' Compensation General Program Rates EMPLOYEES 1-10 11-25 26-35 36-50 51-75 76-100 100-plus DUES $300 $500 $750 $1,000 $1,250 $1,500 $2,500 Dues Payment Method(Required) Check to be sent Sent Invoice Visa MasterCard AMEX PINNACLE Program: Step up today as a PINNACLE member and join others who support the State Chamber/AIA at the highest levels.PINNACLE Level (optional) $35,000+ APEX $25,000 SUMMIT $10,000 PEAK $5,000 CROWN Contribution to the State Chamber PACIn dollarsContribution to the AIA PACIn dollarsPACS Payment Method(Required) Check to be sent Sent Invoice Visa MasterCard AMEX