Membership Application Form

Please fill out the following form to pay for a one year membership in Provider Resource Organization.

REQUIRED INFORMATION

Contact:
Daycare Name:
Phone Number:
Email:
Street Address:
City:
State:
Zip:
Login:
Password:

Please choose which Membership you are applying for:

Bronze Membership - $35.00 Benefits include Chapter Meetings, Quarterly Newsletter, one admission to the PRO Conference at the member price, and listing of name, address and phone on website.

Silver Membership - $45.00 Benefits include Chapter Meetings, Quarterly Newsletter, one admission to the PRO Conference at the member price, listing of name on website, 25% discount on a rental of a PRO conference vendor table, and hyperlink to your business website and/or email address on the PRO website.

Gold Membership - $70.00 Includes one employee membership and other benefits include Chapter Meetings, Quarterly Newsletter, one admission to the PRO Conference at the member price, listing of name on website, 25% discount on a rental of a PRO conference vendor table, and hyperlink to your business website, email address, facebook, twitter, and a description of your daycare on the PRO website.

Please enter the number of employees you wish to include in your gold membership.

Employee Membership - $25.00 each. Benefits include all Chapter Meetings and one admission to the PRO Conference at the member price.

Total $

Please choose one of the selections below:

Exempt:		Comments:
Certified:
Other:
Registered:
In Process:


Please enter the letters above into the box above and then click Join Now to continue:

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Membership Application Form