NEOCA Membership 2025 Paypal

NEOCA Membership 2025:

January 1, 2025 to December 31, 2025
Instituition / Agency Grantee*
Name of EOC Project*
Contact:*

First NameLast Name
Title:
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Format: (000) 000-0000.
E-mail*
example@example.com
Registration
prevnext( X )
EOC Institutional Membership
This membership includes 2 votes at the NEOCA 2025 business meeting and qualifies your program participants to apply for the NEOCA Scholarships 2025

$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

Total

$0.00
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
Name

First NameLast Name

Payment Methods

Debit or Credit Card

Choose from one of the PayPal options to make your payment.

NEOCA Membership 2025: