Organizational Membership Form

LASACT Organizational Membership Form

P.O. Box 80235 Baton Rouge, Louisiana 70898-0235 | www.LASACT.org
Membership Year: July 2026 — June 2027
It is understood that applications for Organizational Memberships are subject to the approval of the LASACT Board of Directors. In order to vote, hold office, and benefit from member discounts, an individual membership must be held.

Dues are $250 annually and are payable on July 1 each year to cover the period of July 1 through June 30.
Contact Person Information
Membership Type
Organization Name
Name

Last NameFirst Name/M.I.
Email Address (Required)
example@example.com
Mailing Address
(Street Address, City, State Zip Code)
Work Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Position Title
Payment Information

$10 credit card convenience fee will be applied to all membership applications
My Products
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New Organizational Member
Dues are $250 annually and are active during the calendar year from July 1 to June 30. Price includes: $250 Annual Dues + $10 transaction fee for all credit/debit card payments.

$260.00 Quantity

Renew Organizational Membership
Dues are $250 annually and are active during the calendar year from July 1 to June 30. Price includes: $250 Annual Dues + $10 transaction fee for all credit/debit card payments.

$260.00 Quantity
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LASACT Organizational Membership Form