Indiana Middle Level Education Association
Membership Form  (For Joint Memberships with AMLE, please see our website)
Sign in to Google to save your progress. Learn more
Email *
Name/Position *
School *
Address (#, Street, City, ZIP) *
Email
School Phone
Please Complete This Section for an Institutional (School) Membership, or the Next Section for an Individual Membership
Clear selection
Individual Membership
Clear selection
Payment (Use section that applies)  Purchase Order # (an invoice will then be sent).  OR
Check will be sent to IMLEA, 11025 E 25th, Indianapolis, IN 46229
Clear selection
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy