APMA Membership Fees Membership Form Company Name * First Name * First LastName * Last Email * Member license # (if applicable) Phone Company Website Company Address Company Address Address Line 1 Address Line 1 Address Line 2 Address Line 2 City City State AlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyoming State Zip Code Zip Code Company Address # of Employees Do you employ any veterans? Yes No List all cities/areas that you provide services: APMA Membership Dues - Active & Allied * Allied Member Dues - $1551 Active Member Dues - $1551 Active Member Dues - $3103 Active Member Dues - $155 If paying for more than one person, list additional names: Donation to Scholarship Fund * NONE $25 $50 $100 $250 $500 $1000 $1500 $2500 Total Submit
