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How to become a PALS, Inc. Member

Please complete the following form and a representative from PALS will contact you:

Seeking Info: Free      
Individual: $35   Annual Sponsor:  $250-$999
Dual/Family: $60   Patron:  $1000
Lifetime Member: $500      

  First Name: Last Name:
  Address: City:
  State: Zip Code:
  Phone: Email:

Participation Level:
  Loved one with special needs name:
  Loved one's date of birth:
  Loved one’s relationship to you: