Please provide the following membership information:

Yes I wish to join!	Regular Member - $30.00 (APA Natl Member also) Associate Member - $35.00 (Not an APA Natl Member) Corporate Member - $75.00 ( 3 individuals 1 is an APA Natl Member) Corporate Membership Names
Membership Type	New     Renewal
Name
Title
Company
Street Address
Address (cont.)
City
State
Zip Code
Work Phone
FAX
E-mail
Are You an APA National Member?	Yes        No
If Yes, You National Membership Number
Are You a CPP or FPC?	CPP        FPC
What Payroll System do you use?
How many employees do you pay?
I am interested in meetings covering the following topics Select the topics that you have an interest in. This will help us determine the content of our Chapter meetings.	401(k) Plans   Aliens/Visas   Cafeteria Plans   Check Fraud   Child Support/Garnishments   Direct Deposit/ACH   Disaster Recovery   Employee Self Service   Employee/Independent Contractor   FLSA Requirements   Fringe Benefits   IRS Issues   Local Tax Issues   Mergers & Acquisitions   Sarbanes-Oxley Requirements   SSA Issues   SUTA Dumping   Third Party Sick Pay   Wage & Hour Issues
Referred/Recruited by:	Please complete the name of LVC member that referred/recruited you so that they receive credit during our Membership Drive!
Comments or Suggestions?