School Membership Application

Date*
Date Format: MM slash DD slash YYYY
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 - 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
Total Due
$0.00
*Please Note: Eighteen percent (18%) of membership dues are used for lobbying purposes and are not tax deductible.
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
- Auto Renewal Invoice for future Annual Terms
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