Membership Application

Purchase Order Number 
Name or Principal's Name
School Name:
County of School:
Name of School Contact if school registration:
Email address:
Individual Membership: Title or position:
School Street Address:
City:   State:   Zip:
Phone number:
Fax number:
KMSA Region:

Group box School Categories of Membership

Number of certified staff:
Click correct number from list below:|
1-19  staff members (1 vote)    $  50
20-39 staff members (2 votes)  $  70
40-59 staff members (3 votes)  $  90
60+                           (4 votes) $110

Group box Individual Categories of Membership:
Student/Retiree Membership (Non-voting)  $25
Parent Membership (Non-voting) $25
Regular Membership $35
Dual KMSA/NMSA Membership $90
(Dual membership entitles you to full benefits of both organizations)
 

Box 3062 Frankfort, Kentucky  40603
Email KMSA
Date last updated: 02/26/2008