Online Membership Form

Please complete the below online form.

After completing the online form, send a check via mail made payable to Oregon Permit Technicians Association

Mail to:
OPTA
PO Box 829
Hillsboro, OR  97123

For those who prefer the manual approach, you may download and print the PDF version of the application located here.


 

Name: *

Address: *

City: *

State: *

ZIP/Postal Code: *

Work Phone: *

Email Address: *

Company or Organization:

Jurisdiction:

ICC Permit Technician Certified: *

Yes

No

ICC Membership #:

Certification #:

Membership Type: *

Governmental Member (bona fide employee of any political municipality)

Associate Member (individual, firm, corporation or association not affiliated with a political municipality)

Honorary / Retired Member (individual confirmed by OPTA Board of Directors)

Dues Category: *

Individual dues (1-3 persons) $40.00 per person

Individual dues (4 to 10 persons / organization) $150.00 maximum

Individual dues (11 or more persons / organization) $175.00 maximum

PLEASE HAVE EACH INDIVIDUAL FILL OUT A SEPARATE MEMBERSHIP APPLICATION.

New Member: *

Yes

No

Renewal: *

Yes

No

(If you're a human, don't change the following field)

Enter your name:

Your first name.

(If you're a human, don't change the following field)

Enter your name:

Your first name.

(If you're a human, don't change the following field)

Enter your name:

Your first name.

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