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            Secure PACE Membership Update Form
            * This Field is required Required field | Information

            This form is for existing PACE members.

            • Use this form to request changes to your PACE membership information, including name, contact information, school information, and/or credit card payment information.
            • To switch your monthly payments from a credit card to bank draft, change your membership plan, or cancel your membership, please call 1-877-640-7223 (PACE).
            • If you are interested in joining, renewing, or upgrading your membership, go to the Join page.
            1. Enter Current Member Information (required)Fill in as many of these fields as possible to help us find your member record.
            Membership Number:
            		 Invalid Input
            First Name:
            		 Invalid Input
            Last Name:
            		 Invalid Input * This Field is required
            Preferred Email:
            		 Invalid Input * This Field is required
            2. Select Information to Update (required)Select all that apply.
            Reason(s) for change:
            		 Invalid Input




            3a. Enter Updated Name/Contact InformationFill in only those fields that need to be updated OR fill in all fields.
            First Name:
            		 Invalid Input  
            Middle Name: Invalid Input
            Last Name:
            		 Invalid Input  
            Preferred Email:
            		 Invalid Input  
            Preferred Email Type:
            		 Invalid Input
            Alternate Email: Invalid Input
            Phone Number:
            		 Invalid Input          Invalid Input      format: xxx-xxx-xxxx
            Alternate Phone Number: Invalid Input     Invalid Input      format: xxx-xxx-xxxx
            Mailing Address:
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            Mailing Address Apt/Suite: Invalid Input
            City:
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            State:
            		 Invalid Input  
            Zip Code:
            		 Invalid Input  
            3b. Enter Updated School/Graduation InformationFill in only those fields that need to be updated OR fill in all fields.
            School Name: Invalid Input  
            School Type: Invalid Input        Other:
            School District: Invalid Input  
            School County: Invalid Input  
            School State Colorado
            Position: Invalid Input  
            Grades: Invalid Input  
            Subjects: Invalid Input  
            College of Education: Invalid Input  
            Expected Graduation Date: Invalid InputInvalid Input 
            3c. Enter Updated Payment InformationIf you are making changes to your payment type, all fields are required.
            Card Type:
            		 Invalid Input * This Field is required
            Name on Card:
            		 Invalid Input * This Field is required
            Credit Card Number:
            		 Invalid Input * This Field is required
            Card Expiration Date:
            		 Invalid InputInvalid Input * This Field is required
            Reason for update:
            		 Invalid Input


            4. Review Changes and Submit Request (required)Enter any additional information below. Please click submit button only once.
            Additional Information: Invalid Input  
            Interested in getting
            more involved?
            check all that apply




            Invalid Input



            Having technical problems with your online application?
            3c. Enter Updated Payment InformationIf you are making changes to your payment type, all fields are required.
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