MassPAC Membership Online Application Form

MassPAC Membership Application - Annual Fee $499

Type of Application*

Have you been a MassPAC member before?

Payment Options (Choose One)*

You can upload your purchase order in the section below. We have added the option of submitting payment electronically thourgh our QuickBooks system - this option will appear on the emailed invoice.

Please upload your Purchase Order here:

Upload your Purchase order in PDF format. You will receive an invoice via email.

Max. file size: 15 MB.

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xPurchase Order Number:

Please enter your district's purchase order number.

Purchase Order Number:

Please enter your district's purchase order number.

District Business Office Email Address:*

Please provide the business office email address to receive your MassPAC invoice.

Special Instructions?

Please inform us of any special instructions for your P.O. or invoice.

DISTRICT Information:

Name of School District*

Type of School:*

District/School Information:*

Name of Special Education Administrator	Administrator Email

SEPAC Information

Please list the SEPAC Information that will appear on the MassPAC website's NEW list of current MassPAC members.

SEPAC Name:	SEPAC Email Address:	SEPAC Website:	Facebook Page Name

SEPAC Logo

Upload your SEPAC Logo or other image that will appear on your listing on the MassPAC Members page.

Accepted file types: (jpg, png, pdf), Max. file size: 15 MB.

SEPAC Officer Information

SEPAC Officer #1

Name:	Title:	Phone#	Email:

SEPAC Officer #2

Name:	Title:	Phone#	Email:

SEPAC Officer #3

Name:	Title:	Phone#	Email:

SEPAC Officer #4

Name:	Title:	Phone#	Email:

SEPAC Officer #5

Name:	Title:	Phone#	Email:

Additional comments/requests:

MassPAC Membership Application - Annual Fee $499

DISTRICT Information:

SEPAC Information

SEPAC Officer Information

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