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KASSP and National Association of Secondary School Principals Membership Application

Last Name:
First Name:
School Name:
Mailing Address:
City:	State: Zip Code:
School AC/Phone:
E-mail Address:
Home Address:
Area Code/Home Phone:
Mail Preference:
Choose edition of Principal Leadership:
Membership Categories (choose one):
1. KASSP	2. NASSP & KASSP	3. NASSP Only
Individual Membership $100	Individual Membership $318*	Individual Membership $218*
Institutional Membership $100	Institutional Membership $318*	Institutional Membership $218*
Retired Membership $10	Retired Membership $50	Retired Membership $40
		Educator Membership $70

Check/Money order made payable to KASSP (Note: Mail to KASSP, PO Box 46, Danville, KY 40423. Membership is not in effect until payment received.)

Purchase Order My school/district has issued purchase order number for the dues listed above.

I have printed this membership form, submitted to my district, and a check will be mailed in the near future.

Please mail/fax an invoice to my school district. Fax No.: (i.e. (859) 236.3388)

Don Turner, Executive Director
Tom Brown, Associate

219 South Fourth Street
Danville, KY 40422
(859) 236-7230

Mailing Address
P.O. Box 46
Danville, KY 40423-0046