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Affiliate Membership Application

 
Affiliate membership in the Northern California Chapter is designed for MPI members who have selected another chapter as their primary chapter, but would would also like to receive all MPINCC mailings and event notifications, including the Membership Directory, and be listed in both the print and online Membership Directories.

The annual fee is US $100.00. Affiliate membership is effective on the date payment is received.  Complete the Credit Card Authorization Form for the payment of your Affiliate membership dues. Or pay by check payable to MPINCC and mailed to MPINCC, 2440 Camino Ramon, Suite 273, San Ramon, CA  94583.

If you have any questions before submitting your application, feel free to reach out to our office at (925) 355-1912 or email info@mpincc.org.

Name

(Member number must be included to validate primary membership)

 
Member Type

Once we receive this form and your payment, your Affiliate membership will be activated.  Payment may be made by credit card (authorization form above required) or by check payable to MPINCC and mailed to:

MPINCC
2440 Camino Ramon, Suite 273
San Ramon, CA  94583

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