Registration Form

How do I become a part of the hottest networking group in the Valley?

Step One - Fill out the registration form:
Name     
      
Title     
      
Business Name     
      

Address
Street     
      
City     
      
State     
      
Zip     
      

Phone
Work     
      
Home (optional)     
      
Fax     
      
Email     
      
Interested in becoming a board member     
    Yes   No  
Would you like to host one of our meetings?     
    Yes   No  
Which of the following committees would you like to serve on?    
     Membership
Newsletter
Fund Raiser
  
Other area of specialty that you would like to contribute    
    
  

 


Step Two- Send in your payment:

Current membership fee is $25.00 per member; Agency memberships of up to 5 individuals per agency are $75.00 annually. Membership commences January of each year. Executive Committee reviews memberships.

Mail your check made
Payable to: NETPA
Attention: Bob Blaylock 
P.O. Box  32233
Phoenix, AZ  85064-2233

You may also bring your check to the next meeting. You will receive a receipt as well. Membership dues questions? Email:  bob.blaylock@safeway.com 

Step Three- Come to the next meeting!

Get more meeting information!

Membership information needed? Email: denisejones@azdes.gov
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