Business Associate Application
Please note that the Utah Association of Charter Schools reserves the right to refuse any application that does not align with the organization's vision and mission. Please contact Royce Van Tassell at 801-836-7028 or royce@utahcharters.org
Organization Name *
Organization Mailing Address *
Organization Phone Number *
Organization Website *
Please provide a 100 word max company description to be included on the UAPCS Business Associates Directory webpage *
Please provide your company logo to be included on the UAPCS Business Associates Directory webpage *
Required
Primary Contact Name *
Email Address *
Phone Number *
Business Associates Directory Category Listing *
If "Other", please specify *
Membership Levels *
Required
Method of payment *
Required
Authorized Signature *
Date of Signature *
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