State Association Membership New State Membership Member Level * - select Member Level - State Membership (fewer than 250 individuals) - $ 500.00 250-499 Members - $ 1,000.00 500-749 Members - $ 1,500.00 750-999 Members - $ 2,000.00 Total Amount On Behalf Of Organization Organization Name * Email * Street Address * City * Country * - select Country - United States State/Province * Choose country first Postal Code * Upload a listing of your entire membership. See Instructions for Membership Listing Upload Membership Listing Please enter a Username to create an account. If you already have an account please login before completing this form. Username * Check Availability Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores. Password Confirm Password Provide a password for the new account in both fields. Create NSPMA User Account First Name * Last Name * Email Address * Payment Options Payment Method Credit Card I will send payment by check Credit Card Card Type - select - Visa MasterCard Amex Discover Card Number * Security Code * Expiration Date * -month- Jan Feb Mar Apr May Jun Jul Aug Sep Oct Nov Dec -year- 2023 2024 2025 2026 2027 2028 2029 2030 2031 2032 2033 Billing Name and Address Billing First Name * Billing Middle Name Billing Last Name * Street Address * City * Country * - select - United States State/Province * Choose country first Postal Code * Review your contribution