NEA- ESP - NCESP Org. Application Form





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National Council for Education Support Professionals

Organization Membership Form

(Please print out this form, then fill it out and mail it, with your membership payment, to the address given below.)

MAILING INFORMATION FOR ORGANIZATION

_________________________________________________________
Name of Organization
_________________________________________________________
Address
_________________________________________________________
City StateZip
_________________________________________________________
PhoneFAX number E-mail

MAILING INFORMATION FOR ESP PRESIDENT

GRADE LEVEL

__Pre-K

__K-12

__Higher Ed

ORGANIZATION DUES

1-100 members	$ 75.00	2 votes
101-200 members	150.00	4 votes
201-300 members	325.00	8 votes
301+ members	400.00	11 votes

TYPE OF MEMBERSHIP

__New Organizational Membership

__Renewing Organization

PAYMENT ENCLOSED

__Check $ ________________

Please do not send cash. Make check payable to NCESP and mail with this form to NCESP, NEA - ESP Quality, 1201 16th St., NW, Washington, DC 20036

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