Text Box: Memberships: Annual: $50/yr Student: $15/yr Retired Educator: $15/yr   To renew: - Fax your P/O to: (540) 832-7666 - Renew online at: www.vaascd.org - Mail your check to:       VASCD       3308 Clay Street Hopewell, VA 23860             Member Information Form

 

***Works best when viewed in Internet Explorer***

 

Please complete this form in its entirety. Thank you!

 

 

Check one:��� �� New Member�������� ��� Renewal

 

 

Name:��

 

Position/Title:��  

 

School/Organization:���

 

School Division:��

 

Region:�� �(click here for Region List)

 

Preferred Mailing Address:��

 

Business Phone Number:��

 

Fax:��  

 

E-mail (required):��  

 

**Do not use your �back� button � you will lose all your information.

 

 

Please print and fax this form to: (540) 832-7666

 

Membership questions? Call Judy at (434) 466-7466