To join PSATS as an Associate Member, please complete this form and submit it. Someone will contact you about your membership.

Type of Associate Membership

Municipality (other than a township of the second class) 5,000 population and under – $250
Municipality (other than a township of the second class) 5,001 to 10,000 in population and under – $500
Municipality (other than a township of the second class) over 10,000 population – $1000
Business Partner – $250
Other – $250

Name *

First

Middle

Last

Title/Position

Municipality (if applicable)

County

Population

Company (if applicable)

Address

Address Line 1

Address Line 2

City

State

Zip Code

Daytime Phone

Cell Phone

Fax

Email *

Associate Membership Application