Membership Registration


2017 – 2018 Membership Application (pdf version) 

 School Name
 School type
 Grade Levels (Ex. K-6, 6-8, K-12)
Membership # optional
Is it an additional membership?
Is this a residence address?
Shipping Address for membership package, please use street address for UPS delivery.
 Street
 Street 2
 District
 County
 City, State, Zip  ,  , 

Please use state abbreviation. ( e.g. NY, PA )

 Country
Do you want to purchase an additional membership such as
Team B, Team C ?





  Mailing Information for Newsletter  

 First Name
 Last Name
 Day time phone#
 Home Phone
 Fax
 Email
 Street
 Street 2
 City, State, Zip  ,  , 

Please use state abbreviation. ( e.g. NY, PA )

 Country

 

 Total
 Credit Card Type
 Credit Card Number
 CVV code What is the CVV Code?
 Expiration Date /
Card Holder Name
Card zip code

   Items in BOLD are required fields.