Apply for Membership

Please read the terms and conditions and check to accept them below. Then fill out the registration form as completely and accurately as possible. Once you have finished and submitted the questionnaire, our staff will review the application and within a week will inform you (via the email you provided) whether you have qualified to become a member.

Terms and Conditions:

Provide as much of the information below as possible (asterisked items are required)
Completing this form does not constitute acceptance as a Defense Alliance member. You will be contacted by a member of the Defense Alliance regarding membership status.
Non-disclosure policy: The Defense Alliance will keep any information that you submit private until your organization is accepted as a member. At that point, basic information only will be released to the main website (organization name, website, location, line of business).

Company Contact Information

Name of Organization^*

Company Website (example.com)^*

Primary Contact Address^*

Company Location (city)^*

Company Location (state)^*

Zip Code^*

Primary Contact Name^*

Primary Contact Title

Primary Contact Email^*

Primary Phone

Accept Terms and Conditions?^*