Member Registration

Individual Membership: $50.00 annual fee per person
Agency/Group Membership: $150.00 annual fee allows 4 employees to join for the price of 3! To qualify for this group discount, all employees must meet the membership eligibility requirements and be employed with the same agency.
Items in Bold are required.
First Name:
Middle Name:
Last Name:
Gender:  Male   Female
Title:
Email:
Address:
City:
State:  Zip: 
Phone:
Fax:
Jurisdiction:
Employer:
(What day of the week begins with the letter “F”?)
Additional Attendees
I would like to register  more people for this employer.
(Up to 15 More)

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  • Due to the coronavirus pandemic and for the safety of our members, in-person meeting have been canceled until further notice.
  • The virtual Free Fall Friday Series is a great way to stay informed on current topics! See the 'meeting' page for more information.
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