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Sustaining Member Application
2023 Sustaining Membership (Company) Application
Company Name
*
Sustaining Member Contact Name
*
First
Last
Sustaining Member Contact Email
*
Sustaining Member Contact Phone
*
Sustaining Membership Level
*
Choose the desired sustaining membership level for your company
Bronze $750
Silver $2,200
Gold $3,500
Chrome $6,500
Diamond $10,000
Platinum $25,000
October 2023 Adviser Advertorial
Please schedule the advertorial included with my benefits for the October 2023 issue (only guaranteed for Chrome and above).
Are you planning to run content in the February 2023 issue of the Adviser?
Please note: content deadline is 12/15/22
Yes
No
Would your company local reps like to have the opportunity to speak at local Chapter CE meetings?
Yes
No
If yes, please list speaker name, email and Chapter that they would speak at.
*Please note that not all reps will be chosen to speak and that providing this information does not imply any agreement with CAPCA. All speakers must be approved.
Any specific expectations of sustaining membership?
*
No
Yes
If yes, please describe:
Commitment to Sustaining Membership
*
I have the authority to commit my company to the membership level selected and understand the company will be invoiced accordingly.
Sustaining Membership Terms
The rights, privileges, membership benefits and unused portion thereof of CAPCA Sustaining Members applies only to the Company purchasing membership and cannot be transferred or assigned to said Company’s subsidiary(ies) or any other entity(ies) the Company has full or partial ownership in. The rights, privileges, membership benefits and unused portion thereof of CAPCA Sustaining Members applies only to calendar year the Company purchases membership for (Calendar Year being January 1st through December 31st) and cannot be transferred or rolled over to any subsequent Calendar Year.
Please email invoice to:
*
Enter Email
Confirm Email
Any specific invoice instructions (including mailing address, cc or parent company name)?
OPTIONAL Ad Agency Contact Name
First
Last
OPTIONAL Ad Agency Contact Email
Auto Renew for 2024
*
Yes, auto renew for 2024
No, I will renew on my own in 2024
We'll reach out in the fall to update your information and send an invoice if you choose to auto renew your 2024 Membership.
Sustaining Member Acknowledgement Specifications
URL link to be listed on CAPCA.com/sustaining-members
Company tag line to be listed on CAPCA.com/sustaining-members