Association of Developmental Disability Providers

Association of Developmental Disabilities Providers

Online ADDP Membership Application

Please complete this brief form to Join ADDP.

	Organization:
	Address:
	City:
	State:	Zip Code:
	Phone:
	Fax:

Tell us about the Executive Director, President, or CEO.
	Name:
	Title:
	Phone:
	Email:

Please tell us who will be the contact for ADDP, if the contact person is not the Executive Director, President, or CEO.
	Name:
	Title:
	Phone:
	Email:

Tell us a little bit about your organization, so that we can better meet your needs.
	Federal Taxpayer Id:
	Principal DMR Purchacing Region:
	Number of Employee:
	Number of FTE's:
	Total Operating Budget :
	DD Services Budget:

Note: Membership dues are based on your organization's developmental disabilities [DD] services budget.

Annual Dues

DD Budget Size

$600

Under $500,000

$1200

Between $500,000 and $1 million

$1740

Between $1 million and $3 million

$2040

Between $3 million and $5 million

$2400

Between $5 million and $7 million

$3000

Between $7 million and $10 million

$3600

Between $10 million and $15 million

$4200

over $15 million