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WAPA
Wisconsin Autism Providers Association Membership Application
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* Indicates required question
Date
MM
/
DD
/
YYYY
Company Name
Your answer
Name
Your answer
Email
Your answer
Phone Number
Your answer
Address
Your answer
Counties Served
Your answer
WAPA's annual membership fees are based off of total clients served. Please indicate your level below.
*
Less than 50 clients - $2,500/year
50-100 clients - $4,000/year
101-200 clients - $7500/year
200+ clients - $12,500/year
Once set up, we will send an invoice for membership dues.
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