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Educational Member Registration
Educational Member Registration
optimaadmin
2023-04-28T13:44:05+00:00
Educational Member Registration
AASP-IL Membership Registration
Todays Date
(Required)
MM slash DD slash YYYY
Your Name
(Required)
First
Last
Business Name
(Required)
Business Address
(Required)
Street Address
Address Line 2
City
ZIP Code
Work Phone
(Required)
Mobile Phone
Email:
(Required)
Website
Text Reminders
Check here if you would like your Mobile Phone included in event reminder texts.
Please list your mobile provider
(Required)
EX: ATT; Boost; C-Spire; Consumer Cellular; Google Fi; H20 Wireless; Metro by T-Mobile; Mint Mobile; Page Plus; Red Pocket; Republic Wireless; Simple Mobile; Sprint; T-Mobile; Ting: Tracfone; Ultra Mobile; US Cellular; US Mobile; Verizon; Virgin Mobile; Visible; Xfinity Mobile
Preferred Method of Contact
(Required)
Email
Phone
Membership Dues
(Required)
I agree
Payment of Dues constitutes an agreement and authorizes AASP-IL to send Association related
information / materials to you via mail or email.
Membership Type: Regular $400; Associate $400; Multiple Locations for Shops include $50 for each
additional location. Educational $250; Student $25.
Membership dues will auto-renew unless cancelled. Cancellations need to be issued in writing 30 days prior to cancellation.
Annual Dues - $250
Annual Dues
Price:
$400.00
Payment Options
(Required)
One time, Credit Card, 3.5% Fee
Recurring, Annual Credit Card Payment, 3.5% fee (please authorize recurring payment)
Check
ACH
*For all credit card payments, the processing fee is included at checkout.
*ACH payment is initiated as you complete this form.
*AASP-IL will then set up a link to your account. Check your bank account for a small deposit from AASP-IL.
*Verify this deposit and note the 6 digit code.
*Text the 6 digit code, along with your Business Name to Julie @ 630.561.3041.
*We will then confirm the payment.
This process may take a few days, depending on our mutual response times and the banks.
Processing Fee
Price:
$0.00
Total
Bank
(Required)
Account Number
(Required)
Routing Number
(Required)
Complete online form & indicate check number & mailed date.
Please send check with
AASP-IL Dues
on Memo line to:
AASP -IL• 1005 W Huron St •Chicago IL •60642
Credit Card
(Required)
Card Details
Cardholder Name
List Additional Location Address - Phone Number - Email - IL UDL
(Required)
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