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
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Title
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Dr.
Ms.
Mrs.
Mr.
First Name
*
Your answer
Last Name
*
Your answer
School
Your answer
District/Institution
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Email Address
*
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Position
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Assistant Principal - Elementary
Assistant Principal - Intermediate
Assistant Principal - Middle
Assistant Principal - High School
Assistant Superintendent - Instruction
Assistant Superintendent - Personnel
Assistant Superintendent - Special Education
Business Representative
CATE Director
CATE Assistant Director
CATE Instructor
Chief Academic Officer
Chief Technology Officer
College/University Administrator
College/University Instructor
College/University Student
Curriculum Coordinator
Deputy Superintendent
Director - Assessment
Director - Early Childhood
Director - Elementary
Director - Instruction
Director - Middle Grades
Director - Professional Development
Director - Secondary
Guidance Counselor
Instructional Coach
Principal - Primary
Principal - Elementary
Principal - Intermediate
Principal - Middle
Principal - Secondary
Retired Educator
State Education Agency Staff
Superintendent
Teacher - Primary
Teacher - Elementary
Teacher - Middle
Teacher - Secondary
Other
Other Position
If you selected "Other" above, please tell us what you do.
Your answer
Address
Your answer
Address 2
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City
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State
Please provide state abbreviation.
Your answer
Zip
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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)
Choose
Individual
Full-time 2 or 4 Year College Student
First-Year Teacher
Institutional 3 Designated
Institutional 3 Undesignated
Purchase Order Number (optional)
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Questions/Comments
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