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NCEA Department of Boards and Councils
2013 Membership Registration Form
(For membership year January 1, 2013 - December 31, 2013)
(First-time memberships begin immediately and run through December 31, 2013.)
Sign up early and receive benefits for the rest of the current year free.
_______________________________________________________
Name of Board/Council/Commission
_______________________________________________________
Name of Institution
_______________________________________________________
Mailing Address
_______________________________________________________
City/State/Zip
(______) _______ - __________________
Daytime Phone
(______) _______ - __________________
Fax Number
_______________________________________________________
E-mail address
_______________________________________________________
Name of Chairperson
_______________________________________________________
(Arch)Diocese
_______________________________________________________
Person Responsible for Payment
_______________________________________________________
Mailing Address for Payment
_______________________________________________________
City/State/Zip
_______________________________________________________
Daytime Phone
Please check the type of board of education for your jurisdiction:
| ___ Single School, Parish, or Private Board |
___ Diocesan Board |
| ___ Regional Board (serving 2 or more schools) |
___ Individual Membership |
| ___ Religious Education Board |
___ Student Membership |
| ___ Total Education Board |
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Total number of Board members: __________
Total annual Board membership fee: $ ___________ (See the chart below. Make check payable to NCEA.)
___ Bill the Institution
___ VISA ___ MasterCard ___Amex ___Discover Ex. Date ______/______
Card Number ____________________________________________
_______________________________________________________
Print Name Exactly as on Card
_______________________________________________________
Cardholder's Signature
Membership Fee
| School, Parish, Private, Religious Education, and Total Education Boards |
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10 or fewer members:
11-15 members:
Over 15 members:
|
$205 Yearly Group Membership
$250 Yearly Group Membership
Add $15 for each person over 15.
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| Regional Boards (2 or more schools served by one board) |
|
10 or fewer members:
11-15 members:
Over 15 members:
|
$245 Yearly Group Membership
$280 Yearly Group Membership
Add $15 for each person over 15.
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| Diocesan Boards |
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10 or fewer members:
11-15 members:
Over 15 members:
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$260 Yearly Group Membership
$330 Yearly Group Membership
Add $15 for each person over 15.
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| Individual Memberships |
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Individual Student:
Individual administrator:
(without a board)
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$85
$175
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Send the board roster containing the name, mailing address, and e-mail address of each board/council/commission member, along with this form and payment to:
Membership Office
National Catholic Educational Association
PO Box 63221
Charlotte, NC 28263-3221
Phone: (571) 257-0010. Fax: (703) 243-0025
services@ncea.org
To Index Page of Board Services
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National Catholic Educational Association
