Join/Renew - Northwest Indiana Influential Women Association

Register Your Company, Organization, or Self

To get involved as a member, please use the online form below or send an email expressing your interest to info@nwiiwa.org. NWIIWA is an inclusive organization—not exclusive. We celebrate everyone regardless of race, color, religion, gender, national origin, age, or individuals with disabilities.

If you are a new registrant, please fill out and submit the form below.

Join Now / Renew Membership

First Name*
Last Name*
Company*
Email*
Phone*
Membership Type*
Additional Contacts
Contact Name Contact Title Contact Email

2 Additional contacts are allowed with the Associate Corporate Membership. Use the + button to add an additional contact.
Additional Contacts
Contact Name Contact Title Contact Email

Unlimited contacts are allowed with the Premier Corporate Membership. Use the + button to add an additional contact.
Total (Billed Annually)
$0.00
Updating your membership type will change your annual billing amount. We will contact you with any additional fees associated with your membership.
Billing Contact*
Billing Email*
Billing Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Contact Name	Contact Title	Contact Email

Contact Name	Contact Title	Contact Email