Vendor Partner Program Vendor Partner Application 1. Organization InformationOrganization Name*Geographic Region(s) Served*Primary Contact Name* First Last Primary Contact TitlePrimary Contact Email* Mailing Address* Street Address Address Line 2 City AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Telephone*FaxWebsite Authorized Signature*Date* 2. Fee CalculationCorporate Vendor Annual Membership Levels*Platinum Membership $1,500Gold Membership $1,000Silver Membership $5003. Payment MethodPlease mail your check and make payable to: Louisiana Association of Public Charter Schools1555 Poydras Street, Suite 750New Orleans, LA 701124. Listing on LAPCS WebsitePlease enter a description and upload your logo for use on the Association's website.Description of Company*Please enter a 50-word description of your company.Company Logo*Please upload a jpg, gif, eps, ai or png file of your logo on a white background. You can send up to 3 images. Drop files here or Accepted file types: jpg, gif, eps, ai, png. Vendor Member Category ListingSelect only 2 categories. Accountability, Data & Assessment Back Office & Start Up Services Board/Executive Leadership Development Classroom & Teacher Supplies Compliance & Student Information Systems Curriculum & Textbooks Facilities & Maintenance Financial & Auditing Services Food Services Fundraising & Grant Writing Furniture Home School Services HR/Talent Management/Staffing Insurance & Retirement Benefits IT/Technology Legal Assistance Online/Blended Learning Professional Development Special Education Needs Strategic Planning Technology Don’t fit into any of these categories? Other Category:For questions or more information, contact Donyell McGlathery, Director of Strategic Partnerships at email@example.com or 504-274-3666.PhoneThis field is for validation purposes and should be left unchanged.