School Membership Application

Apply for CAPPS 2024 Membership

Date*
MM slash DD slash YYYY
School Name*
Membership Status*
- New School Member
- Renew School Membership
2024 Early Bird Membership Renewal Code - EB2024 (Early Bird Discount Ends 12/31/2023
Your Name*
First Last
Your Title*
Your Email*
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
School Website Address

*MUST include the entire website address, including http://
Example: http://www.MyWebsite.com
Phone*
Fax
School Description
Please state how you would like your listing to read. (You may type "no changes" if this is a renewal.)
Multiple Locations
If your School offers mulitple campus locations, please enter total number here. We will use your website to pull up the addresses.
Additional Contact #1 - Name
First Last
Additional Contact #1 - Title
Additional Contact #1 - Email
Additional Contact #2 - Name
First Last
Additional Contact #2 - Title
Additional Contact #2 - Email
Additional Contact #3 - Name
First Last
Additional Contact #3 - Title
Additional Contact #3 - Email
Please select from dropdown menu. Choose the dollar value of your Institution's Gross Annual Tuition Revenue (California).*
School Dues Tiers
Discount Code

2024 Early Bird Membership Renewal Code - EB2024 (Early Bird Discount Ends 12/31/2023
Total Due
$0.00
*Please Note: Eighteen percent (18%) of membership dues are used for lobbying purposes and are not tax deductible. CAPPS does not offer refunds.
Payment Method*
Invoice and payment option can both be selected. Auto renewal invoice will be sent in time for Early renewal discounts (around November next year), if selected.
- Pay By Credit Card
- Request Invoice
- Check in the Mail
Credit Card

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name

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