Membership Application
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:
Number of certified staff: Click correct number from list below:| 1-19 staff members (1 vote) $ 40 20-39 staff members (2 votes) $ 60 40-59 staff members (3 votes) $ 80 60+ (4 votes) $100
Box 3062 Frankfort, Kentucky 40603 Email Webmaster Date last updated: 06/12/2006