PMA | Membership | New Member Funeral Member Association

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New Member Application for Washington State

Name

First Name *

Middle

Last Name *

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

Country

Address Line 1 *

City *

State/Province *

Postal Code *

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.

Submitter Information

Submitter Name

First Name *

Last Name *

Submitter Phone (Required)

Submitter Email (Required)

Relationship to Applicant

How Did You Learn About People's Memorial?

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. This service is intended for long term storage; please disregard for cases where death is imminent.

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

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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.

Your total payment will be

Your credit balance will cover

Your credit card will be charged

Your bank account will be charged

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