2011-2012 MAESP-NAESP

Joint Membership Application and Spring Conference Registration Form

First Name:		Last Name:
Street Address:		City:
State:		Zip Code:
Home Phone Number:		Cell Phone:
Email Address:
School Name:
Street Address:		City:
State:		Zip Code:
Employing District:
Position:
School Telephone:		School FAX:
Send Mailing:	Home School	Your MAESP District:
MAESP Dues: Dues for first year administrators are $209 (one time benefit only) For IRS purposes, 95% of MAESP membership dues are deductible as a work related expense.
NAESP Dues If you wish to join NAESP at this time, indicate the amount of your NAESP dues by selecting one of the choices below. Add the amount of your NAESP dues to your total remittance.
District Dues: Return to MAESP Membership page for more information about membership categories
Spring Conference Registration Check here if you would like to include registration fee of $233 for the MAESP Spring Conference.
ELN Webinar and Social Media Check here if you would like to include subscription fee of $99 for the ELN Webinar and Social Media (fee valid until 1/1/2012).
Building Fund Donation: Check here if you would like to donate $35 toward the 2011-2012 MAESP Building Fund.
Total Remittance:		How are your membership dues paid?
The following demographic information would greatly assist MAESP in association planning for elementary principals:
Years in current position:		Years in Principalship:
Years in MAESP:		Years in NAESP:
Method of Payment:		Purchase Order #: