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Welcome to the Ohio Provider Resource Association!
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| We hope you enjoy your introductory membership rate and take full advantage of all the great benefits OPRA has to offer!
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| Reminders and Details:
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• Ohio Provider Resource Association engages in lobbying, and under federal law, 10% of membership dues are not deductible as a business expense.
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• OPRA’s Membership Year is from January 1 through December 31.
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• The dues structure described herein is an introductory rate applicable solely to new members. Introductory membership dues are structured to increase in year two as outlined on the membership dues rates located under the Join OPRA tab. Revisions may affect the dues structure for following years.
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• Please complete the following information as accurately as possible to help us serve you better - Thank you!
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• Upon completion of this form, an invoice will be emailed to you within 1-2 business days. If you have any questions regarding your OPRA Membership, please feel free to contact us at (614) 224-6772.
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| Thank you for your interest to join the OPRA Community! How did you hear about us?
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Organization Information
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| Type | |
| Organization Name | |
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| Main Phone | |
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Physical Address
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| CHECK if Billing address and Physical address are the SAME |
| Address | |
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| State | |
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Billing Address
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| Please provide Billing Address ONLY if different from above.
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| CHECK if Billing address is DIFFERENT from Physical address |
| Address | |
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Your Contact Information
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| First Name | |
| Last Name | |
| Title | |
| Email | |
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Organization's CEO, Executive Director or Owner (if different from above)
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| First Name | |
| Last Name | |
| Title | |
| Email | |
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Billing Contact (if different from above)
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| First | |
| Last | |
| Title | |
| Email | |
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Additional Organization Information
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| Please list all other subsidiary entities which your organization owns that fall under this membership:
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| Total # Employees, in all locations:
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| Approximately, how many individuals do you serve a year?
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| Please select all applicable services your organization provides: (use SHIFT, CONTROL or COMMAND to multi-select)
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| Please choose the following counties you provide services in:
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| | All 88 Counties | Adams | Allen |
| | Ashland | Ashtabula | Athens |
| | Auglaize | Belmont | Brown |
| | Butler | Carroll | Champaign |
| | Clark | Clermont | Clinton |
| | Columbiana | Coshocton | Crawford |
| | Cuyahoga | Darke | Defiance |
| | Delaware | Erie | Fairfield |
| | Fayette | Franklin | Fulton |
| | Gallia | Geauga | Greene |
| | Guernsey | Hamilton | Hancock |
| | Hardin | Harrison | Henry |
| | Highland | Hocking | Holmes |
| | Huron | Jackson | Jefferson |
| | Knox | Lake | Lawerence |
| | Licking | Logan | Lorain |
| | Lucas | Madison | Mahoning |
| | Marion | Medina | Meigs |
| | Mercer | Miami | Monroe |
| | Montgomery | Morgan | Morrow |
| | Muskingum | Noble | Ottawa |
| | Paulding | Perry | Pickaway |
| | Pike | Portage | Preble |
| | Putnam | Richland | Ross |
| | Sandusky | Scioto | Seneca |
| | Shelby | Stark | Summit |
| | Trumbull | Tuscarawas | Union |
| | Van Wert | Vinton | Warren |
| | Washington | Wayne | Williams |
| | Wood | Wyandot |
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Introductory Membership Dues
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| New OPRA Provider Members will receive a one-time introductory dues discount of 35%. First year membership dues are structured to increase in year two. Revisions may affect the dues structure for following years.
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| Please record your organization's EGR for 2025.
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| In figuring your Estimated Gross Revenue, do NOT include revenue from fundraisers, United Way, gifts and donations. If your organization provides services to non-DD populations, you only need to include the revenue related to individuals with I/DD.
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| EGR | |
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| Please choose your membership dues level based on your EGR:
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| Membership | |
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| Please review and select one of the following payment plans for your 2025 dues payments.
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| Annual
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| | Your annual dues payment is due on or before March 15th. A 5% discount is applied to the entire dues amount if this payment plan is selected, and payment is received, by March 15th! |
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| Semi-Annual
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| | Your 1st semi-annual dues payment is due on or before March 15th. Your 2nd semi-annual dues amount will be invoiced by the end of June. A 5% discount is applied to the 2nd half dues amount if this payment plan is selected and the 1st payment is received by March 15th! |
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| Quarterly
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| | Your 1st quarterly dues payment us due on or before March 15th. Successive quarterly dues amounts will be invoiced by the end of each following quarter. |
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| Please select one of the following payment plans for your dues payments.
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| Payment Plan | |
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| You will be sent an invoice within 1 to 2 business days based on the membership dues level and payment plan you selected
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| Your dues payment is due upon receipt of your invoice
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Terms and Conditions
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| By signing the form below, the Organizational Representative understands that an OPRA Staff member may confirm subscriptions and inquire about any additional employee subscriptions. The Organizational Representative also consents to the organization’s listing as an OPRA Member on any/all published materials.
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| I certify that the information on this form is current, accurate, and complete.
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| Signature | |
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A LOOK AHEAD
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| OPRA offers a special 35% discount as an introductory rate for first year members. Second year OPRA members and beyond pay the full standard dues rate for OPRA Membership. We encourage new OPRA members to talk with other members about the value of OPRA membership and how you can get the best return on your dues investment.
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