2024-2025 LAPCAE Membership Form

Membership Registration Form

Annual membership term runs from August 1 - September 30, 2024
Membership Type:

Individual MembershipOrganizational Membership
Member Information
Contact Person Name

First NameLast Name
Organization
Job Title
Email
example@example.com
Phone Number
Please enter a valid phone number.
LAPCAE Region
Number of Members*
Organizational Members (If more than 10 members, please use the link below to download an Excel Spread sheet to enter member information.)
LAPCAE Organizational Members Spreadsheet
File Upload

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Individual Membership 1 - 10 Members
$50.00 Quantity



Organizational Membership (11-20)11 - 20 Members
$500.00



Organizational Membership (21-30)21 - 30 Members
$800.00



Organizational Membership (31-40) 31 - 40 Members
$1,100.00



Organizational Membership (41-50)41 - 50 Members
$1,400.00



Organizational Membership (51-60)51 - 60 Members
$1,700.00



Organizational Membership (61-70) 61 - 70 Members
$2,000.00



Organizational Membership (71+)71+ Members
$2,300.00



Subtotal

$0.00

Tax

$0.00

Total

$0.00
Please Select Payment Method*
Payment can be made by Check, Direct Deposit, or Credit Card.

Check Payments: Mail Check made out to LAPCAE to: Kaye Sharbono, 115 Cherokee Trail, Delhi, LA 71232.

Direct Deposit: For Direct Deposit, email YOUR Direct Deposit paperwork to kayesharbono@gmail.com. Appropriate account information will be completed and returned to the authorized designee for direct payment.

Credit Card: To pay via Credit Card, use the payment link in the confirmation email you will receive with your Invoice. There is a 4% processing fee to pay by credit card. Credit card payments are accepted via Square.
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Membership Registration Form