Membership Application

 

June 1, 2006                                                                                                                  Invoice # 060106           

 

Annual Parent Advisory Council Membership Dues

 

Membership options-check one                                 O   1 year =     $ 190.00     

                                                                                                            O   2 years=    $ 350.00    

O   3 years=    $ 530.00

   

Annual membership in Masspac covers the period from July 1 through June 30. Renew now to maximize membership benefits. Dues cover standard overhead costs, an extensive member resource package, PAC Training Institutes, In-District workshops, lending library access, disability awareness resources, educator/appreciation awards, discounts on publications, newsletter, e-news updates, access to the website and list serve. The PAC member package changes each year to provide new materials for an expanding resource library to benefit parents, families, students and staff.

 

Institution purchase orders must be addressed to:

 

MASSPAC     PO Box 167     Sharon, MA   02067

 

Payment for membership is due within 30 days of receipt of invoice generated by a completed application form and accompanying purchase order or check. Thank you for your support and PAC membership to Masspac.

 

Please mail applications with purchase orders. Do not fax.

Credit card payments accepted via internet at www.paypal.com. Email recipient:  info@masspac.org

 

 

Type of Application:  _____New        _____Renewal

 

Data required:

 

1)School District (specify if regional, charter or vocational)______________________________________________________

 

School District Address______________________________________________Superintendent______________________

 

Special Ed Director ___________________________________Phone___________________Website:_________________

 

 

2).  Council Verification Data*

 

Parent Contact ___________________________________Title_________________________________

 

Address _________________________________Town/City___________________State/Zip _________

 

Phone _______________________Email _______________________________Fax________________

 

 

3).  Member package shipping information (will be shipped in September 2006)

 

Name_______________________________Shipping address:_______________________________________________

 

_________________________________________________________________________________________________