Invoice Request: Annual Membership
Please include the first name, last name, and email address for each person to be listed on the invoice, up to six. If you need fewer than six memberships, you may leave those sections of the form blank. Each individual listed will receive an email for instructions to set up and/or renew their USPAA account. The first individual listed will receive the invoice for payment.
How many annual memberships would you like included on the invoice ($75/each)?
1 = $75
2 = $150
3 = $225
4 = $300
5 = $375
6 = $450
First Individual
First Name
Last Name
Email
Should the individual requesting the invoice be included on the invoice for annual membership? (Check "no" if the person requesting is doing so on behalf of someone else, but does not need a membership themselves.)
Yes
No
Second Individual
Second Individual on Invoice (If Applicable)
Second Individual on Invoice (If Applicable)
Third Individual
Third Individual on Invoice (If Applicable)
Third Individual on Invoice (If Applicable)
Fourth Individual
Fourth Individual on Invoice (If Applicable)
Fourth Individual on Invoice (If Applicable)
Fifth Individual
Fifth Individual on Invoice (If Applicable)
Fifth Individual on Invoice (If Applicable)
Sixth Individual
Sixth Individual on Invoice (If Applicable)
Sixth Individual on Invoice (If Applicable)
Submit