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Supporting Partners
Supporting Partner Application
AASSA
Supporting Partner
Application
*
Required
Thank you for your interest in becoming a Supporting Partner of AASSA. We look forward to working together and thank you for your support of our organization and our region.
Instructions:Please complete the form below and Submit. Upon receipt of your application, we will review your application and if approved we will invoice you for the annual membership fee which covers membership for the academic year from July 1 through June 30.
Part I. Information About Your Organization
Name of Organization:
*
required
Name of Representative:
Prefix
First
*
required
Middle
Last
*
required
Suffix
Mailing Address:
Address 1
*
required
Address 2
Address 3
City
*
required
State
*
required
Region
Zip Code
*
required
(ex. 06108 or 06108-0809)
Country
Phone
Ext
Email Address:
*
required
Organization's Website:
*
required
Part 2: Membership Level
Please select your desired membership level.
Supporting Partnership Level:*
Silver Partner $1,250
Gold Partner $2,500
Platinum Partner $5,000
If you have any questions regarding membership, please do not hesitate to contact the AASSA office.
Thank you again for becoming a Supporting Partner of AASSA.
Please send a confirmation email to the address below*:
© 2019 AASSA
1911 NW 150 Ave, Suite 101 Pembroke Pines, FL 33028 Phone 954-436-4034
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