Join

Agency Name: _____________________________________________
Date: ______________

Address: ______________________________________________________________________
Agency Representative to PAFCO: _________________________________________________

Phone: ______________________________________ 
Fax: _____________________________
Email Address:_________________________________________________
Agency website:________________________________________________

Agency Legislative District: ___________ 
Agency Areas of Interest: _____________________

PAFCO Membership Dues Structure and Agency Budget

$ 500 Basic PAFCO Membership
$ 750 $500,000 to $1 million
$ 1,000 Up to $3 million
$ 1,250 Up to $4 million
$ 1,500 Up to $5 million
$ 1,750 Up to $7 million
$ 2,000 Up to $10 million
$ 3,000 Up to $15 million
$ 5,000 Up to and above $20 million

Your annual contribution level is $____________________________

Payable to PAFCO Education Fund 501(c) 3
Payable to Protecting Arizona's Family Coalition Advocacy 501(c) 4
Please send your dues check and completed form at your earliest convenience to:

Suzanne Schunk, Treasurer
PAFCO Education Fund or Protecting Arizona's Family Coalition (PAFCO Advocacy)
2100 North Central Ave, Suite 225
Phoenix, AZ 85004