UFAA Affinity Application
Company Name
*
Name
*
First Name
Last Name
Title
*
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
Please enter a valid phone number.
Email
*
example@example.com
Website
*
Please describe your company, products and/or services, and how they will benefit UFAA and its members.
*
What would you like to offer UFAA and or its members?
*
What would you like in return from UFAA?
*
Description of how you will track and report the results of the program to UFAA.
*
Submit
Should be Empty: