Membership Application Instructions add instructions here Select An Option Organizational A public or private organization, agency or clinic that provides or promotes health and prevention services to children and youth. Members at this level are entitled to member benefits for all additional sites registered and paid for. Base amount = $450 + $75 per each additional site Education Partner $50 Annually Schools may apply for membership as an Education Partner and are then entitled all membership benefits. Sustaining Sponsorship Price of Level Selected (Price Range: $3000 - $5000 Annually) Select Level $3000: $3000 Annually $4000: $4000 Annually $5000: $5000 Annually Applicants wishing to enroll in a Sustaining Sponsorship may select a sponsorship level, only if it is more than the Organization Level with all of your sites. Sustaining Sponsorship members are entitled all membership benefits. Levels: $3,000, $4,000, or $5,000 Enter Contact Information Prefix (i.e. Mr. Mrs. Dr.) First Name Last Name Suffix (i.e Jr. Sr. III) Designations E-mail Family NameBusiness Name View Membership Terms Next Please select a valid membership option and fee item if exist Powered By GrowthZone
