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APA Professional Membership Application – SRC 2026APA Admin2026-02-09T23:00:55+00:00

SAVE 15%!

Exclusive discount for SRC 2026 Attendees – get 15% off an APA Professional Membership!

AMERICAN POLICYHOLDER ASSOCIATION MEMBERSHIP APPLICATION

APA Professional Member

All information submitted is confidential and will not be shared with the public.

Name(Required)

First Last

Business Name

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone(Required)

Secretary / Assistant - Phone or E-Mail

How did you hear about the APA?(Required)

Check all that apply and please list the source

Referred by Friend/Associate

Saw APA Presentation/Display

Social Media

News Media

Association Journal

Other

Please list source

Polo Information

Sizing(Required)

Please select a size

Payment Information

How would you like to pay?(Required)

Annual

Monthly

Professional Membership (Annual) - 15% OFF!

SRC 2026 Special - 15% OFF your first years membership!

Price:

Professional Membership (Monthly) - 15% OFF!

SRC 2026 Special - 15% OFF your first years membership!

Price:

Per month. 12 month minimum term.

Credit Card(Required)

Fiduciary & Ethics Pledge Agreement

Your membership to The American Policyholder Association is contingent upon you agreeing to the Fiduciary & Ethics Pledge. You must read this document carefully before submitting your application. Checking below certifies that you are legally authorized to act on behalf of your company/organization in agreeing to this pledge, and have read and agree to it. Further, you will communicate these responsibilities to all members of your company or organization and will monitor their behavior to assure compliance. Lastly, you understand that the APA reserves the right to revoke your membership if you violate the pledge.

VIEW THE PLEDGE

Fiduciary & Ethics Pledge Agreement(Required)

I have read and agree to the Fiduciary & Ethics Pledge Agreement

Submit Application

Terms of Use Agreement(Required)

By submitting this form I accept the APA Terms of Use (including billing agreement) and I certify that the information contained herein is accurate and truthful.

Name(Required)

First Last

Business Name

Address(Required)

Street Address Address Line 2 City State ZIP Code

Email(Required)

Phone(Required)

Secretary / Assistant - Phone or E-Mail

How did you hear about the APA?(Required)

Check all that apply and please list the source

Referred by Friend/Associate

Saw APA Presentation/Display

Social Media

News Media

Association Journal

Other

Please list source

Polo Information

Sizing(Required)

Please select a size

Payment Information

How would you like to pay?(Required)

Annual

Monthly

Professional Membership (Annual) - 15% OFF!

SRC 2026 Special - 15% OFF your first years membership!

Price:

Professional Membership (Monthly) - 15% OFF!

SRC 2026 Special - 15% OFF your first years membership!

Price:

Per month. 12 month minimum term.

Credit Card(Required)

Fiduciary & Ethics Pledge Agreement

Your membership to The American Policyholder Association is contingent upon you agreeing to the Fiduciary & Ethics Pledge. You must read this document carefully before submitting your application. Checking below certifies that you are legally authorized to act on behalf of your company/organization in agreeing to this pledge, and have read and agree to it. Further, you will communicate these responsibilities to all members of your company or organization and will monitor their behavior to assure compliance. Lastly, you understand that the APA reserves the right to revoke your membership if you violate the pledge.

VIEW THE PLEDGE

Fiduciary & Ethics Pledge Agreement(Required)

I have read and agree to the Fiduciary & Ethics Pledge Agreement

Submit Application

Terms of Use Agreement(Required)

By submitting this form I accept the APA Terms of Use (including billing agreement) and I certify that the information contained herein is accurate and truthful.

Title

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