WASCA Membership Application - Professional Membership

Professional Membership
PLEASE NOTE: If you plan on paying by check, please print and complete this form and send it in with your payment instead of filling out the form below.

PLEASE NOTE: For Professional Membership, individuals who are affiliated with an ASC are not eligible for Professional Membership. For more information, please see Categories of Membership.
Name of Member*
First Last
Mailing Address or Business Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Phone*
Member Email*

As a WASCA member you have access to the member list serv.
Professional Membership Fees*
New members receive a 50% discount the first year of membership.
New Member
- I am joining WASCA for the first time
Fee Schedule*
- Professional Membership - $720
Fee Schedule New Member*
- Professional Membership - $360
As a new or renewing member of WASCA, I will make a $100 contribution to WASC PAC
- As a new or renewing member of WASCA, I will make a $100 contribution to WASC PAC
As a new or renewing member of WASCA, I will make a $100 contribution to WASC PAC
- As a new or renewing member of WASCA, I will make a $100 contribution to WASC PAC
PAC Contribution $100
Price:
Fees are due upon joining and are billed annually.

*Pursuant to IRS code section 6033(e), WASCA hereby provides notice that 45% of membership dues will be allocated to lobbying activities in 2025. As such, 45% of your dues paid to WASCA are considered non-deductible.
TOTAL
$0.00
Credit Card*

American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
Card Number Expiration Date Security Code Cardholder Name
INQUIRIES: Contact the WASCA office at info@wasca.net.

WASCA Membership Application – Professional Membership

Professional Membership

Professional Membership Fees*

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