ONLINE MEMBERSHIP FORM - For Credit Card Payment ONLY

PLEASE READ THIS BEFORE FILLING OUT FORM

1. This form is ONLY for paying with a credit card
2. To cover our extra cost for taking credit cards, a 3% handling charge will be added to your total payment amount
 
MEMBER INFORMATION
PHA/COMPANY
EXECUTIVE DIRECTOR/CONTACT PERSON
FOR ASSOCIATES: PRODUCT/SERVICE
ADDRESS
CITY
STATE
ZIP
PHONE
EMAIL
MEMBERSHIP CATEGORY (insert "1" in front of the applicable amount)
 
For PHA Membership, "units" means Public Housing plus HCV units administered
PHA 0 - 50 units x $50 =
PHA 51 - 150 units x $90 =
PHA 151 - 300 units x $155 =
PHA 301 - 600 units x $220 =
PHA 600 and > units x $300 =
Associate Membership x $200 =
SUBTOTAL
3% handling charge
TOTAL