Membership Application

Make an impact. Join PAC/LAC and help improve the care of mothers and their babies in your hospital or organization.

 

In order to become a member, please:

  1. Download and Complete the Membership Application.
  2. Pay for your Membership(s).
  3. Send us your completed application (and payment if applicable).
    • Fax: 818.708.2950
    • Email: info@paclac.org
    • Mail:  5530 Corbin Ave. Suite 323,  Tarzana, Ca 91356 

If you choose to pay online, you will receive an order number in a confirmation email. When submitting your application, please reference the order number (included in your confirmation email) so that we can process your application quickly.