South Carolina ASCD Membership Form
Purchase orders can be scanned and emailed to: billing@scascd.org

Payment Instructions
After submitting your South Carolina ASCD membership application, we will email you an invoice with three payment options: 1.) Mail-in payment; 2.) Pay by credit card; 3.) Pay with PayPal
Title
First Name *
Your answer
Last Name *
Your answer
School
Your answer
District/Institution
Your answer
Email Address *
Your answer
Position
Other Position
If you selected "Other" above, please tell us what you do.
Your answer
Address
Your answer
Address 2
Your answer
City
Your answer
State
Please provide state abbreviation.
Your answer
Zip
Your answer
Phone Number
Please use (###) ###-#### format.
Your answer
Membership Type *
Individual ($35); Full-time 2/4 Year College Student ($10); First-Year Teacher (Free); Institutional ($75 for first 3 members/$25 for each additional membership)
Purchase Order Number (optional)
Your answer
Questions/Comments
Your answer
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