On-line Membership / Conference
Registration Form

Thank you for your support in MASBA

Schools can also register by downloading the Membership Application Form, filling it out and email it back to us.

You can also fill in the form below. Please provide as much info as possible.

Online Membership Form (and Annual Conference Badge Request - see below)

We are Current MASBA Members - Please fill in the Board Members Attending below
*School District Enrollment		Membership Dues - check the appropriate box
Up to 9,999		$ 500		Please invoice us for our MASBA Membership PO#
10,000 to 19,999		$ 750
20,000 and larger		$ 1,000
Individual – School Board Member		$ 300
For current School Board Members whose School Districts are not members of MASBA. An individual membership allows the school board member to participate in the Annual Conference and all related MASBA events for the current year.
Educational Service Centers (ESC)		$ 1,000
Amigo (Friend of MASBA)		$ 250
Former School Board Members, Educators or those with a general interest in MASBA and the betterment of education. An Amigo (Friend of MASBA) membership allows the member to participate in the Annual Conference and all related MASBA events for the current year.

MASBA Contact Information

Name:
Business / School District:
Actual Enrollment:
Total Amount: $
Phone #
E-mail Address:
Address:
City:
State:
Zip Code:

	For Convention
MASBA Member Information Badge Request	Need Badge

Superintendent’s Name:
E-Mail:

Board Members / Atendee Information

Need Badge

Name:
E-mail:
Name:
E-mail:
Name:
E-mail:
Name:
E-mail:
Name:
E-mail:
Name:
E-mail:
Name:
E-mail: