2025-2026 LAPCAE Membership Form

Membership Registration Form

Annual membership term runs from June 5, 2025 - September 30, 2026
Individual MembershipOrganizational Membership
Member Information
Contact Person Name

First NameLast Name
Organization
Job Title
Email
example@example.com
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
LAPCAE Region
Number of Members*
Organizational Members (If more than 10 members, please use the link below to download an Excel Spread sheet to enter member information.)
LAPCAE Organizational Members Spreadsheet

PLEASE DOWNLOAD THE FORM TO YOUR COMPUTER THEN UPLOAD BELOW.

DO NOT WRITE DIRECTLY ON THIS FORM
File Upload

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Organizational Membership (1 - 10)
$50.00 per member

$50.00 Quantity



Organizational Membership (11-20)
11 - 20 Members

$500.00



Organizational Membership (21-30)
21 - 30 Members

$800.00



Organizational Membership (31-40)
31 - 40 Members

$1,100.00



Organizational Membership (41-50)
41 - 50 Members

$1,400.00



Organizational Membership (51-60)
51 - 60 Members

$1,700.00



Organizational Membership (61-70)
61 - 70 Members

$2,000.00



Organizational Membership (71+)
71+ Members

$2,300.00



Subtotal

$0.00

Tax

$0.00

Total

$0.00
Please Select Payment Method*
Payment can be made by Check, Direct Deposit, or Credit Card.

Check Payments: Mail Check made out to LAPCAE to: Kaye Sharbono, 115 Cherokee Trail, Delhi, LA 71232.

Direct Deposit: For Direct Deposit, email YOUR Direct Deposit paperwork to kayesharbono@gmail.com. Appropriate account information will be completed and returned to the authorized designee for direct payment.

Credit Card: To pay via Credit Card, use the payment link in the confirmation email you will receive with your Invoice. There is a 4% processing fee to pay by credit card. Credit card payments are accepted via Square.
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Membership Registration Form