2025-2026 FBLA ARIZONA MEMBERSHIP TIER REQUEST FORM

2025-2026 FBLA ARIZONA MEMBERSHIP TIER REQUEST FORM

In order to help us get you a membership invoice that includes both the national and state membership fees, we need you to complete this form letting us know what membership tier level you are requesting for this school year. FBLA Arizona will invoice you so DO NOT pay the national invoice as it does not include the state membership fees. Thank you for your help on this.
CONTACT INFORMATION
Chapter Adviser Name*

First NameLast Name
School Name*
(i.e. Westside High School)
Chapter Name*
Chapter Adviser Email*
Chapter Adviser School Number*

Area CodePhone Number
Chapter Adviser School Cell Number*

Area CodePhone Number
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
CTE DIRECTOR CONTACT INFORMATION
CTE Director Name*
CTE Director Phone Number*

Area CodePhone Number
CTE Director Email*
example@example.com
FINANCE CONTACT INFORMATION
Finance Contact Name*
Finance Contact Title*
Finance Contact Email*
example@example.com
CTE Director Phone Number*

Area CodePhone Number
By using the Arizona Intra-Curricular Membership Tier Level Chart, please select your membership tier level for this year:

5 to 40 Members41 to 80 Members81 to 100 Members101 to 125 Members126 to 160 Members151 to 175 Members176 to 200 Members201 to 225 Members226 to 250 Members250+ or District WideOther
If you answered other above, please list how many students you believe you will have this school year in FBLA and contact the State Adviser.
Is this request for your chapter only, or are you sharing a tier level with another chapter at your school?*

Yes, I will be sharing a membership tier level with another chapter at our school this yearNo, I will not be sharing a membership tier level this year
Sharing Chapter Adviser Name
Chapter Name of Sharing Chapter
Do you need a quote, invoice, or both? Check All That Apply*

I need a quote to be generatedI need an invoice generatedI will need both a quote and an invoice
I understand that after I choose my AZ Tier Level, I will go into the National Membership System (FBLA Connect) and input my members names. I can go back and enter more throughout the year until my pre-paid membership level is reached.*
I understand that I will ignore the National Invoice as it is not correct (doesn't show the AZ Tier Levels nor include the State Fees). I will pay the state office for my membership.*
I understand that I will give the copy of my Membership Invoice to my CTE Director and finance people at my school to be paid. I also understand that the invoice sent from FBLA Arizona NOT the National Office.*
I understand I will not be invoiced until this form is completed.*
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