Online Application

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Become a LeadingAge PA partner

To become a business member of LeadingAge PA, please complete this application. Once approved, you will receive an invoice for membership dues.

LeadingAge PA offers two membership options to businesses:

Business Membership
Joining January 1 through June 30: $1,000
Joining July 1 through November 30: $500* *This rate applies to new members only.

Thank you for your interest in Business Membership. Please complete the following application.

Membership Type

Business Membership Only

Business Membership with Conference Exhibit

Business Name

Business Mailing Address

City, State, & Zip Code

List any Pennsylvania long-term care facilities your firm owns, operates, or manages

Website URL

Upload your company logo(s)

* Photos must be high-quality 300 dpi logos in PNG, JPG, or EPS file

Add another

Primary Contact Name

Primary Contact Title

Primary Contact Phone

Primary Contact Email

Billing Contact Name

Billing Contact Title

Billing Contact Phone

Billing Contact Email

Business Member Terms: Payment of Business Member dues, in full, 30 days from invoice date is required to finalize annual membership. Business Member dues are nonrefundable. Failure to pay within invoice terms will result in member benefit suspension. Failure to pay dues in full 90 days from invoice date will result in membership cancellation.

I have read and accept these terms.

FOR MEMBERSHIP + CONFERENCE EXHIBIT APPLICANTS

Exhibit Contact Name

Exhibit Contact Title

Exhibit Contact Phone

Exhibit Contact Email

Booth Choice

Standard 8' x 10' booth: $3,000

Corner 8' x 10' booth: $3,225

Premium/lobby 8' x 10' booth: $3,550

Exhibit Terms Acceptance

I have read and accept these exhibit terms.

FOR ALL APPLICANTS

Please select a category from the list below to be included in LeadingAge PA's online membership directory. You can select two more categories below, for a total of three categories.

Optional: Second category selection.

Optional: Third category selection.

Name of Person Submitting Application

Email Address of Person Submitting Application

How did you hear about LeadingAge PA?

Questions about Business Membership? Reach out to Hattie Gable, at hgable@leadingagepa.org or 717-790-3941.

Disclosure: LeadingAge PA membership dues are not deductible as a charitable contribution for federal income tax purposes.

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