JEA

Trade Member Registration

Please fill out all of the information below in detail. This information will be used in your online listing with JEA that will be viewed by consumers and industry members looking for your services. Once you have filled out the form below, please print a copy for your records before clicking submit.

After you submit your registration form you will be taken to a confirmation/payment page. To complete your registration you will need to click the payment button. By submitting this form and making your payment you agree in whole and in part to the JEA member terms and code of ethics.

The registration confirmation/payment page will provide you with the option to pay by credit card or bank account via paypal. If you prefer not to use paypal, you may print this form and sign and return it with your check or money order. You must click submit at the bottom of this form to register.



First Name: *
Last Name: *
Title/Position: *
Are you authorized to join on behalf of your company? *
Company Name: *
Website:
E-mail Address: *
Phone Number: *
Street Address: *
Address Line 2:
City: *
State/Province: *
Postal Code: *
Country: *
Additional Physical Location Addresses:
Additional Online Selling Locations:
My Business is Primarily *
If other, please list
What services do you offer? *
Appraisals
Custom Jewelry Design
Gemological Testing
Jewelry Repair
Jewelry Sales - Retail
Jewelry Sales - Wholesale
Lapidary Services
Loose Stone Sales - Retail
Loose Stone Sales - Wholesale
Jewelry Mountings - Wholesale
Jewelry Mountings - Retail
Rough Dealer
Other
If other, please list
By checking the box and submitting this form you agree in whole and in part to the membership agreement and code of ethics. *
Verification Code: ** PLEASE DESCRIBE THIS IMAGE **
Enter Verification Code: *
* Required