.
|
West Virginia
Association of
Secondary School Principals
MEMBERSHIP DUES INVOICE |
MEMBERSHIP DUES
(Disregard if payment has been submitted) |
METHOD OF
PAYMENT |
| Please Select ONE: r Individual Dues:
Circle the proper choices
WVASSP Renewal $130.00 or
New $90.00
NASSP
Renewal $210.00 or New $150.00
Total
Renewal $340.00 or New $240.00
OR
r Institutional Dues: Circle the
proper choices
WVASSP Renewal $130.00 or
New $90.00
NASSP
Renewal $210.00 or New $150.00
Total
Renewal $340.00 or New $240.00
_________________________________________
Amount Due: Circle One Renewal $340.00 or New 240.00 |
Choose payment option: r Payroll
Deduction (complete enclosed form)
r Check/Money Order enclosed
(Payable in U.S. funds)
r Charge my
credit card
r Am. Exp. r Master Card
r Visa
Credit Card No. ____________________________
Expiration Date ____________________________
Name on Card _____________________________
Signature _________________________________ |
Please make check payable to
WVASSP and return form to:
- John Cole, Executive Director
WVASSP
269 Ewing Street
Berkeley Springs, WV 25411
Name
_________________________________________________________________________________
Renewal Membership
____________________ OR New
Membership _______________________
Position
_______________________________________________________________________________
School Name
__________________________________________________________________________
School Address
________________________________________________________________________
School Phone (
) _________________________ School Fax (
) ___________________________
E-Mail Address
_________________________________________________________________________
Home Address
__________________________________________________________________________
Home Phone (
) _____________________________________ |
