2019 Dues Invoice

NOTICE: To Pay Offline, Please print the PDF here and follow the instructions to submit to FACA. To Pay Online, with credit card or P card, please complete the below.

Agency Information

Agency*

Mailing Address*

City*

State*

Zip Code*

County*

Phone*

Primary Email Address*

Head of Agency

Full Name*

Title*

Email*

Phone*

Number of Employee's

Check the Category that corresponds to your number of employees.

$70 flat fee for agencies of 1-5 employees

For 6-10 employees ($20 PER EMPLOYEE)

For 11-25 employees ($15 PER EMPLOYEE)

For 26-50 employees ($12 PER EMPLOYEE)

For 51-100 employees ($10 PER EMPLOYEE)

For over 100 employees ($8 PER EMPLOYEE)

Employee Information

PLEASE PROVIDE THE POSITION TITLES AND THE NUMBER OF EMPLOYEES IN EACH POSITION. ALL EMPLOYEES must be members: including all enforcement & shelter workers, excluding strictly administrative personnel (i.e. bookkeepers, office janitors, etc.). FACA does not need the specific employee names, as these change due to turnover, but does need to know how many employees your agency is budgeted for in each position. If you currently have vacancies that you expect to fill during the year covered by this membership then include that number even if currently vacant

Position*

How Many?*

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Summary

Below you can find your order information.

Order Details

Total Due:

Pay by Check

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