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NCESP State Affiliate Sponsorship Membership Form

Mailing Information For State Affiliate

_______________________________________________________
Name of State Affiliate

_______________________________________________________
Address

_______________________________________________________
City                                State                            Zip

_______________________________________________________
Phone                                    FAX Number                                

_______________________________________________________
Email Address

 

Mailing Information for State Affiliate President

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Last Name                           First Name                            Middle Initial

_______________________________________________________
Address

_______________________________________________________
City                                State                            Zip

_______________________________________________________
Work Phone                        FAX Number                   Alternative Phone

_______________________________________________________
Email Address 

 

SPONSORSHIP DUES      

Platinum            $500.00                 0 votes

Gold                 $400.00                 0 votes

Silver                $300.00                 0 votes

Bronze              $200.00                 0 votes


TYPE OF  MEMBERSHIP      

□ New State Affiliate Sponsorship   
□ Renewing State Affiliate Sponsorship

PAYMENT  ENCLOSED   

□ Check $ ________    □ Other $ _________

All checks should be made payable to NCESP and mailed to:
NCESP
NEA Center for Governance
1201 Sixteenth Street, NW, Suite 813
Washington, DC 20036

Note: Only checks and money orders are acceptable payments through the mail. Please do not send cash.

If you have any questions or would like to request another type of membership form, please call the Center for Governance at 202-822-7173.

_______________________________________________________ 

NCESP State Affiliate Sponsorship Membership Receipt
(Receipt portion returned once payment and form have been received. Please keep a copy of this form for your records before mailing.)

Affiliate Name: ________________________________________   
Amount Paid? $______________

Payment Type:   □ Check (√ No. _______)     □ Other __________

Membership Exp. ___________________  

Received by: _________________________________ 
Date Received: ____/____/_____

National Council for Education Support Professionals


RELATED ITEMS

Click here to download a PDF copy of the State Affiliate Sponsorship Form.


RELATED LINKS

  • anc_dyn_linksNCESP Network
  • anc_dyn_linksNCESP Individual / Associate Membership Form
  • anc_dyn_linksNCESP Organization Membership Form
  • anc_dyn_linksNCESP State Affiliate Sponsorship Membership Form
  • anc_dyn_linksNCESP Constitution and Bylaws
  • anc_dyn_linksNCESP Candidate Nomination Form
  • anc_dyn_linksNCESP NEA Representative Assembly Announcements