School Membership Application

Date*
School Name*
Membership Status*
- New School Member
- Renew School Membership
Please select "New" if you have not been a CAPPS Member in more than two years.
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
First Last
Title Additional Contact 1
Phone Additional Contact 1
Email Additional Contact 1
Additional Contact 2
First Last
Title Additional Contact 2
Phone Additional Contact 2
Email Additional Contact 2
Additional Contact 3
First Last
Title Additional Contact 3
Phone Additional Contact 3
Email Additional Contact 3
Please select from dropdown menu. Choose the dollar value of your Institution's Gross Annual Tuition Revenue (California).*
School Dues Tiers
Total Due
$0.00
*Please Note: Eighteen percent (18%) of membership dues are used for lobbying purposes and are not tax deductible.
Payment Method*
- Pay By Credit Card
- Request Invoice
- Check in the Mail
- Auto Renewal Invoice for future Annual Terms
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.
Credit Card

American Express
Discover
MasterCard
Visa
Card Number Expiration Date Security Code Cardholder Name
Discount Code

School Membership Application

Apply for CAPPS 2019 Membership