LIAPA - LIAPA Membership Registration

LIAPA Membership Registration

Please submit your information

First Name *
Last Name *
FPC/CCP
APA ID
Company
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Please check above if the above Company name will appear on the credit card used for membership.
Job Title
Address
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Phone *
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User Name *
Password *
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Membership Level
Full LIAPA Member

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To pay LIAPA membership fee of $45 via check please mail to the following address.

LIAPA
Attention:
Cheryl Donegan
Verint
175 Broadhollow Road, Suite 100
Melville, NY 11747