Individual Membership Application

INDIVIDUAL Membership Application

You're almost there! Complete this Membership Application and submit your payment to officially become an APPA member. We look forward to welcoming you!
This form is for Individual Applicants only. If you are interested in our Agency, Corporate, Associate, Affiliate, Educational, or Library memberships, please use this link.
Name*

First NameLast Name
Phone Number
undefined
Email*
How did you hear about APPA?*

Social MediaAPPA WebsiteGoogle/Search EngineColleague or FriendSupervisorAttended an APPA Training InstituteEmail or NewsletterAPPA Member Referral
Were you referred by someone? If so, please share their name so we can thank them and recognize their support in helping grow the APPA community!
Job Title*
Agency/Organization*
Major
College/University
Anticipated Graduation Date

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Length of Experience in Community Corrections

Less than 2 years2-5 years6-10 years11-15 years16-20 years21-25 yearsMore than 26 years
Professional Category

AdministratorAttorneyCommissioner/Director/ChiefConsultantEducatorGrant CoordinatorJudgeLine OfficerParole Board MemberPrivateProject DirectorRetiredSpecialistStudentSupervisorTrainerTransition Specialist
Primary Work Sector

AcademiaAdult CorrectionsAdult ParoleAdult ProbationCommunity JusticeJuvenile ParoleJuvenile ProbationJudicialNon-ProfitPretrial ServicePrivateResidentialTreatment Provider
Job Jurisdiction

CityCountyFederalProvinceStateTribalAlaskan VillageOther
Geographic Work Areas

Urban (Population > 50,000)Rural (Population < 50,000)Both Urban and Rural
Payment Information

My Products*

Student Membership

$25.00

1-Year Individual Membership

$50.00

3-Year Individual Membership

$135.00

Lifetime MembershipAPPA members who have been with APPA for at least 10 years, served in an APPA leadership role, and have 25 years of experience in community corrections.

$300.00

Subtotal

$0.00

Shipping

$0.00

Total

$0.00

Credit Card

First Name

Last Name

Credit Card Number

Security Code

Expiration Month

Expiration Year

Billing Address

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

We're excited to have you as part of our community! An APPA team member will be in touch soon with your onboarding details and tips on how to make the most of your membership.
Should be Empty:

INDIVIDUAL Membership Application

Payment Information

We're excited to have you as part of our community! An APPA team member will be in touch soon with your onboarding details and tips on how to make the most of your membership.