Membership Application - Conference for Catholic Facility Management

Associate Partner Member Application

Thank you for your interest in CCFM. Please fill out this form and submit for approval.

Membership Dues

Organization Code

If you were given a code to sign up for an organization, enter it now and hit the Apply button.

One-time administrative application fee: $25.00

Your Dues Rate Type is: Partner member that provides educational and support services $0.00

Add-On Organization Code

You may choose a code so that your representatives can add themselves to your organization's membership. The system will assign a code for you, if you do not choose one.

Contact Information Contact Information

Email *

Re-enter your email *

Prefix

First Name *

Middle

Last Name *

Suffix

Title

Informal Name

Company *

Address 1 *

Address 2

Address 3

City *

State

Zip Code *

Country

Website

Phone Number *

Fax Number

CCMail

Include me in Membership Directories *
Yes No

Include me in Broadcast Email *
Yes No

Username/Password Username/Password

Please enter the Username/Password you would like to use to login to this website.

Your Username must be unique and must be at least 6 characters.
Passwords must be a minimum of 8 alpha-numeric characters with at least 1 number or 1 letter.

Username *

Password *

Confirm Password *

Payment Details Payment Details

Comments

Amount to Charge :

Payment Method:

Enter the name on the bank account according to the information shown on your bank statement. The account number and routing number can be copied from the lower left corner of the check.

Bank Name:
Bank Account Holder Name:
Routing Number:
Account Number:
Account Type:

Name on Card:

Card #:

Expires:

Save payment method for future purchases

Enable Automatic Renewals?

Select "Yes" in order to be enrolled in automatic membership renewal. The above payment method will become your saved payment method, overwriting anything that may have been previously saved and will be used for future renewals. You can change the automatic renewal setting or saved payment method at any time in either the "Payment Method" or "Membership Auto-Renewal" tabs where you edit your profile.

No Yes