PACHSA MEMBERSHIP APPLICATION
PACHSA has three types of memberships, Full Members, Trial Members and Associate Members. All memberships are strictly limited to Pennsylvania counties. Full Members are designated by the Commissioners of the member county. Trial Members are designated by the Commissioners to represent them for a one-year membership in PACHSA. Associate Members are recommended by the Full Member representing the county. All three types of memberships are premised on promoting the development of locally determined, adequately funded, cost effective human services systems which allow consumers to reach their full potential as integral members of their communities.
If a county does not have Full Membership in PACHSA, the Commissioners may designate an organization to represent that County. This organization may enroll as a Full Member immediately or may choose to apply as a Trial Member for a maximum of one year before becoming a Full Member. If a Trial Member is to continue to represent a county after one year, they must become a Full Member. Counties that already have a Full Member may recommend as many organizations as they wish for Associate Membership. The distinctions in benefits between the three types of memberships are listed on the PACHSA Brochure.
The annual cost of Full Membership is assessed based on County Class. A listing of the dues schedule for 2000 can be found on the back of this form. A Trial Membership is $200. Associate Membership is $50.00 per year. To apply for membership, complete the form below and return it to the PACHSA Executive Director, 17 North Front Street, Harrisburg, PA 17101 along with a check for the appropriate amount.
SIGNATURE OF COUNTY COMMISSIONER CHAIR __________________________
(Required for Full Membership or Trial Membership)
NOTE: Applications for Associate Membership will be reviewed by the Full Member of the County for recommendation/approval.
PACHSA DUES SCHEDULE
COUNTY CLASS |
2001 DUES |
|
|
|
|
1 |
$2,190.00 |
|
2 |
$1,971.00 |
|
2A |
$1,752.00 |
|
3 |
$1,285.00 |
|
4 |
$1,227.00 |
|
5 |
$963.00 |
|
6 |
$788.00 |
|
7 |
$526.00 |
|
8 |
$438.00 |