PMA | Membership | New Member Funeral Member Association

New Member Application

First Name * (Required)

Middle Name

Last Name * (Required)

Gender

Female
Male
Other

Birth Date * (Required)

mm/dd/yyyy

(Optional) SSN-Last 4 Digits Only

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Is the applicant deceased?

Contact

Care of (if not applicant or partner)

c/o

Mailing Address (Required)

City (Required)

State (Required)

ZIP Code (Required)

Member Phone Number (Required)

Include area code and dashes. Use this format: ###-###-####

I wish to receive member packet and all correspondence electronically via email.

If Email Only option is not selected, membership packet will be mailed to the address above.

Email (Required)

Submitter Information

Submitter First Name (Required)

Submitter Last Name (Required)

Submitter Phone (Required)

Submitter Email (Required)

Relationship to Applicant

Membership Pricing

Purchase Lifetime Membership (Required)

Document Storage Service is an option for People’s Memorial members. We will scan and store an electronic copy of your Disposition Authorization and other funeral planning paperwork with your membership record for access by your chosen contracted funeral home at time of death.

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Purchase Document Storage Service

Your PMA membership covers only a portion of our education and advocacy efforts. To help us further our mission, please consider adding a donation to your membership purchase today.

Contribution Amount

Payment

Insert card number without hyphens or spaces. If you experience technical issues while signing up, please call our office at 206.325.0489 for assistance.

Credit Card Information

Cardholder Name (Required)

Credit Card # (Required)

Expiration Date (Required)

Security Code (Required)

cardholders
Your security code is the 3-digit code at the end of the signature field on your card's back.

Billing Zip Code (Required)

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged

For Office Use Only

Web/Mbr/Frm

Constituent Type (Required)

Printable Applications

People's Memorial Association is committed to providing funeral consumer education and advocacy to all Washingtonians. With that outreach in mind, PMA provides the membership application in the following languages:

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