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1-800-733-2242
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7:00 a.m. to 5:30 p.m. CT.
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Please call 1-800-733-2242 for assistance with your membership application.
Membership Packages
Our membership packages were created specifically for small-business owners, the self-employed, and other individuals who are responsible for providing benefits for themselves and their families. Our packages focus on discounted products and services for your professional, personal and health care needs.
Choose Your Package  
Select ($60 Monthly Dues)
Value Family ($40 Monthly Dues)
Value Single ($28 Monthly Dues)
Core ($25 Monthly Dues)
Membership Start Date   Note: Start date cannot be in the past
or more than 60 days in the future.
FSR PIN: If you have a Field Service/Sales Representative ID Number, please enter it here.
Member Information * Required
* First Name  
* Last Name  
* Address  
 
* City  
* State  
* ZIP    
* Date of Birth          (yyyy / ex:1972)
* Gender
 
* E-mail   
* Phone   
Marital Status  (optional)
Education Level  (optional)
Dependent Information
With the Value Package, you can select from the Single or Family option. If you purchase the Family option, all of the benefits are available to the primary member, spouse and dependents as outlined. If you purchase the Single option, all of the benefits are available to the primary member only.

Please provide spouse/dependent information if the Family option or Family additional benefits are purchased.

First Name Last Name Date of Birth(yyyy) M / F  
Spouse  
Child  
Child  
Note: Dependents age 19 to 28 must be full-time students.
Age requirements for some benefits may vary.
NOTICE TO WASHINGTON RESIDENTS
You must join through a licensed Representative. Please call 800‑733‑2242
for more information.
© 2014 Alliance For Affordable Services    1-800-733-2242