NEOCA Membership 2024:
January 1, 2024 to December 31, 2024
Instituition / Agency Grantee
*
Name of EOC Project
*
Contact:
*
First Name
Last Name
Title:
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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EOC Institutional Membership
This membership includes 2 votes at the NEOCA 2024 business meeting and qualifies your program participants to apply for the NEOCA Scholarships 2024
$
100.00
Affiliate Membership
This membership is for non-EOC program personnel and does not include voting rights at the NEOCA business meeting but does qualify your program participants for the NEOCA Scholarship.
$
75.00
Phone Number
*
E-mail
*
example@example.com
Note
You can submit the form ahead of payment if payment cannot be made until after September 1. The form will let us know to expect your check or payment via PayPal and will “hold” your membership until payment is received. Mail checks to NEOCA Treasurer Melissa Rosa-Alvarez 1610 Orrington Payne Place Casselberry, Fl 32707
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