Your membership has benefits! It supports our work in meeting the needs of Pennsylvania families challenged with autism spectrum disorders. It also keeps your organization “front and center” in the minds of those very families.
Member Benefits:
>Acknowledgment with a clickable link to your website in our quarterly electronic newsletter
distributed to over 14,000 readers
>Organization logo with link featured on our website
>Discount (25%) to advertise in our quarterly electronic newsletter
>Discounted exhibitor rates at Conference and Trunk or Treat
Organization/Corporate Partners Membership Dues: $400 $200
Please complete the following:
Organization ________________________________________________________________
Primary Contact Name ________________________________________________________________
Address ________________________________________________________________
Phone # _______________________ Fax # _____________________________
E-mail ________________________ Website _____________________________
Send completed form with payment info to:
(Checks payable to Autism Connection of PA)
Autism Connection of PA, 35 Wilson St., Suite 103, Pittsburgh, PA 15223
Email Nicole Cannon– [email protected]– phone 412-781-4116
Credit Card (VISA, MasterCard) ________________________
Card # ___________________________________________
Name as it Appears on Card _______________________________________________
3-digit CID # ___________________
Statement Billing Address _________________________________________________________________________________
Expiration Date _________________
Authorized Signature _____________________________________________________
Organization Membership Form
2019