Membership Form: Vendor (Credit Card)

Please complete the form below to become a SPADD member organization or renew an expiring membership. *Note that processing fees apply when paying dues with a credit card.*

Step 1 of 4

Demographic Information

Organization(Required)

Primary Contact / Voting Member(Required)

First Last

Email Address(Required)

Enter the primary contact’s email address here. You will have a chance to enter additional email addresses for your organization later.

Enter Email Confirm Email

Website

Address(Required)

Street Address Address Line 2 City State ZIP Code

Additional Organization Contacts

As a SPADD member organization, you may add other employees so they can receive SPADD digital correspondence. Please list any additional staff names and email addresses you would like to add. Note: This field is for *new* additions; email addresses that already exist in SPADD’s system will not change.

Would you like to add more employee email addresses?

Yes

Membership Level and Dues Payment

Membership is defined as one agency receiving the benefits, rights, and privileges as established by the organization. Membership levels for providers are determined by annual gross revenue. Details at https://spadd.org/join

Vendor Membership(Required)

Price:

Credit Card Processing Fee

Total

Credit Card(Required)

Credit card payments are securely processed by Stripe. Once submitted, it may take up to 30 seconds for processing. During that time, do not resubmit or refresh this page to prevent duplicate charges.

Card Details

Cardholder Name

CAPTCHA

Demographic Information

Membership Level Details

Additional Organization Contacts

Membership Level and Dues Payment