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PAFPC Membership Application

Governmental Memberships
A governmental membership is for Local Education Agency individuals representing LEAs. Examples of Governmental Units are: School Districts, Charter Schools, Intermediate Units, and Departments of Government.

Non-Governmental Unit Membership
Non Governmental unit memberships are for individuals who are representing private or other (non-governmental) entities. Examples are: Non public administrative units: locally operated neglected and delinquent institutions: and educational vendors and representatives.


Basic membership enables the organizations to identify one representative at a cost of fifty ($50) dollars.

Extended membership enables the organizations to identify up to three representatives at a cost of one hundred dollars ($100). Additional members beyond the first three may be added at a cost of twenty-five dollars ($25) per individual.

Questions
Questions pertaining to the link or online process should be e mailed to Jamie Miller (jamie_miller@iu5.org); Questions pertaining to payment should be e mailed to Jim Sheffer (jmsheffer@aol.com) and general questions pertaining to membership and membership cards should be e mailed to Darlene Reynolds (ddrey43@aol.com). You may also contact your Regional or Alternate Regional representative. Their information can be found on the PAFPC Website at www.pafpc.org.

LEA Name

Private Individuals, Nonpublic administrative units and schools, locally operated neglected and delinquent institutions and/or educational vendors and representatives (Only if not listed above):

Invoicing Contact

Contact Email

Contact Phone

Address

City

State

Zip

Included membership at Basic Membership $50 rate

Representative One (included)

First Name

Last Name

Phone

Included memberships at Extended Membership $100 rate

Representative Two (included)

First Name

Last Name

Phone

Representative Three (included)

First Name

Last Name

Phone

Additional Memberships $25 each

Representative Four ($25)

First Name

Last Name

Phone

Representative Five ($25)

First Name

Last Name

Phone

Comments or Questions?