NDASCD - Membership

This form is to be completed on-line and then printed out to send to us. After entering all of your information, click on the Print button at the bottom of the page. A page with your information will appear. If correct, print the form and mail or fax it to us at the address below.

Directory Information:

Name:
Position/Title:
School/District/Institution:

Work Address:

Work Address (line 2):

City:

State: Zip:

County:

Home Address:

Home Address (line 2):

City:

State: Zip:

Work Telephone: Fax:

Home Telephone:

E-mail:

Send mail to Home Address Work Address

(please check one)

Type of Membership:

Individual Membership (only $25.00 per year)
Dues provide for North Dakota ASCD professional conferences, publishing newsletters, and maintaining an Internet website (www.ndsu.edu/ndascd) for North Dakota educators.

		New Member
		Renewal

Student ($10.00)

		New Member
		Renewal

Payment Information:

Check (made payable to North Dakota ASCD) enclosed

Mail this form along with your check payable to North Dakota ASCD to:
NDASCD
Justin J. Wageman
155C EML Hall -NDSU
Fargo, ND 58105-5057

Fax to: 701-231-9685

Important note:
Membership applies to North Dakota ASCD affiliate only and does not include membership in the international organization ASCD located in Alexandria, VA.

Click the Print button below to review your information. If correct, then use your browser's print button to print the form to send in by regular mail.


Site Manager: Daniel Biel Last Updated: Thursday, 15-May-2003 13:34:53 CDT Designed by Daniel Biel	This WWW page represents views of the author and not necessarily those of North Dakota State University. NDSU is not responsible or liable for its contents.