Membership Form for State Agencies - Online Payment
Institutional Membership $400.00 (10 Voting Members)
Individual Membership $80.00
Please complete the form below. Required items denoted by *
Please provide the name, phone number and email address for each member that you are enrolling.
Upon completion of the form click the "Submit" button. You will then be redirected to the PayPal payment page.
You will receive an email from PayPay confirming your payment.
If you have questions related to this transaction please contact:
Sheri Alberti, Treasurer
NYS Department of Health •Child and Adult Care Food Program
150 Broadway 6th Floor West • Albany, NY 12204
1.800.942.3858 option 2 • 518.402.7252 fax
Email: sheri.alberti@health.state.ny.us
