EmailMe Form - PSCA Plan Sponsor Corporate Membership

Primary Contact Information:

Name *

Prefix First MI Last

Firm/Company *

Title: *

Address

Street Address Address Line 2 City State / Province / Region Postal / Zip Code

Work Number *

### - ### - ####

Cell Phone

### - ### - ####

Work Email Address: *

Alternate Email:

Secondary Contact Information:

Name

Prefix First MI Last Suffix

Title:

Address

Street Address City State / Province / Region Postal / Zip Code

(if different from that of primary contact)

Work Number

### - ### - ####

Email Address:

Plan Demographics:

1.What is the total number of U.S. employees at your company? *

2.What is your industry? *

3.What types of retirement plans does your company sponsor for employees? (Check all that apply) *

Payment Information:

Dues are based on the total number of U.S. employees at your company. If you join Jan.-June you pay 100% of the annual rate, July-Oct. you pay 50%, Nov.-Dec. you pay 100% but renewal will be 1+ year later

Tier:
Tier 1: 1-100 employees
Tier 2: 101-500 employees
Tier 3: 501-1,000 employees
Tier 4: 1,001-10,000 employees
Tier 5: >10,000 employees
Tier 6: Law Firms (regardless of the number of employees)

Regular Rate:

July-Oct. Rate:

I am paying by: *

Check

Credit Card

Credit Card Type: *

Mastercard

Visa

Amex

Discover

Name as it appears on card *

First Last

Credit Card *

Signature *

Clear

Paying by check? Please print a copy of your completed application and send with check payment to: PSCA, P.O. Box 34725, Alexandria, VA, 22334-0725.

Questions? Please call us at 800.308.6714. Dues appearing on this application not valid after 12/31/2025.

Tax Deductions:
Dues, contributions or gifts to PSCA are not deductible as charitable contributions; they may be deductible, however, as ordinary and necessary business expenses. Federal law prohibits a tax deduction for the portion of membership dues attributable to lobbying expenses incurred by the organization. Consequently, for 2025, 10% of your dues are non-deductible in accordance with this provision.