NCAPCS Business Membership Renewal Form

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Business / Company

First Name *

Last Name *

Title Title

Company Description

We would like to use the same company description as shown on the Business Directory.

We would like to update our company description.

(Hold CTRL and click Business Directory to lookup the company description currently shown on your e-business card.)

Updated Company Description

(Enter the company description you would like displayed on your e-business card in our business directory. Maximum 100 words)

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Address *

City *

State *

Zip *

Phone Number *

Email Address *

Company Logo

We would like to use the same company logo as shown on the Business Directory.

We would like to update our company logo

(Hold CTRL and click Business Directory to lookup the company logo currently shown on your e-business card.)

Updated Logo

Drop a file here or click to upload Choose File

Maximum upload size: 15MB

(Upload .jpeg, .gif, or .png files only.)

Payment

Payment Method *

Credit Card

eCheck / ACH

Mail a Check

Membership Tier *

Would you like to enroll in annual recurring payment? *

Yes, we would like to benefit from annual recurring payment.

No, we prefer to make a one-time payment.

Orig. Mem. Date

Current Exp. Date

Standard Exp. Date

Prorated Dues

Credit Card *

Credit Card

Have your check delivered to the following address no later than 10 business days from the date you receive your invoice:

North Carolina Association for Public Charter Schools
242 West Millbrook Road
Raleigh, NC 27609

You will receive your invoice from us within 1 business day

You will receive an emailed invoice within one business day. You will find a Pay Now link at the bottom that will allow you to make your payment online. Select ACH in the online form to enter your information and submit payment. Please submit payment no more than 10 days from the date you received the invoice.

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Acknowledgement of Membership *

We have read and understand the business membership information and terms as shown on URL: ncpubliccharters.org/join-us/business-membership/ including the additional FAQs in the page's direct link

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Authorization of Recurring Payment *

We authorize the North Carolina Association for Public Charter Schools to automatically bill annually the card/account specified on this form in the amount of the selected membership tier minus 10% ($450/yr for Business Partners and $1,350/yr for Corporate Leaders) for the purpose of business membership dues starting November 1, 2019. Any changes to the membership fee structure will be sent to me at least 60 days prior to my next billing and will be applied to my next billing cycle. If we choose to cancel our membership or at least cancel recurring payments, we must express that in writing by emailing josh@ncpubliccharters.org.

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Signature *

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NCAPCS Business Membership Renewal Form

for business members whose membership will expire soon

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