Prospective Member of TOPAA - Parents

Complete form & submit; upon acceptance you will receive an invoice for dues (electronically: Membership@TOPAA.org or at www.TOPAA.org)
TOPAA, P. O. Box #31, Sugar Land, TX 77487-0031

Membership Dues:   effective September 1, 2008 (need-based assistance available*)
____ $25/year for families
____ $15/year for single parent household
____ Donations Appreciated

Name:_________________________________________________________________________

Organization:____________________________________________________________________

Email/Website:___________________________________________________________________

Street:_________________________________________________________________________

City/State/Zip:___________________________________________________________________

Telephone (please specify business and/or personal):_______________________________________

School District:___________________________________________________________________

In which capacity are you joining?  (Attorney, Advocate, and/or Parent):__________________________

What is your interest in this group?_____________________________________________________

What do you hope to gain from TOPAA?_________________________________________________

What do you feel you can contribute to TOPAA?____________________________________________

Other organizations you belong to:_____________________________________________________

Please specify if you have a specific interest: (legislative, support, reform, etc.)_____________________
______________________________________________________________________________

Please provide your child(ren)’s ages and disabilities: _______________________________________
______________________________________________________________________________

Who referred you to TOPAA? (website, search, person – please specify):__________________________

ATTORNEYS/ADVOCATES:  Please complete Attorney/Advocate Form – Both forms are required.
□ I certify that I am not employed by, or receive more than 50% of my income from state, intermediate or local education agencies, nor am I an attorney who represents or has represented such an agency within the past five years, nor am I a member of a school board.  Exceptions are made on an individual basis by our membership committee.

*The TOPAA membership committee and Board of Directors is always willing to consider reasonable requests to have all or a portion of the membership fees waived in  It is also possible to become sponsored by another member or be rewarded a scholarship to be used towards annual dues.  Additionally, TOPAA is an accredited 501(c)(3) corporation pursuant to the IRS regs, and any contributions you make are deductible.