Missouri Interscholastic Press Association
Please complete this form as a building (including all advisers) if at all possible. Thank you!
Email address
Membership Form 2017-2018
Name of School
Your answer
School Address
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City
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Zip Code
Your answer
Enrollment
Number of advisers in school
Yearbook (YB) Information
Please leave blank any questions that do not apply.
YB Publication Name
Your answer
YB Delivery
YB Web address
If online content is supplementary to the print book or the same as the book, please include a URL here. If the website provides readers with unique content online, please add Online as a publication below, and pay the membership fee for that publication.
Your answer
YB Facebook Handle
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YB Twitter Handle
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YB Instagram Handle
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Other YB Social Media
Please list name & handle.
Your answer
YB Adviser Name
If you have more than one yearbook adviser, please enter them at end.
Your answer
YB Adviser Email
Your answer
YB Adviser Phone
Your answer
YB Adviser Cell Phone
Your answer
Newspaper/Newsmagazine (NP) Information
Please leave blank any questions that do not apply.
NP Publication Name
Your answer
NP Type of Publication
Frequency of NP Publication
NP Web address
If online content is the same to the print product, please include a URL here. If the website provides readers with unique content online, please add Online as a publication below, and pay the membership fee for that publication.
Your answer
NP Facebook Handle
Your answer
NP Twitter Handle
Your answer
NP Instagram Handle
Your answer
Other NP Social Media
Please list name & handle.
Your answer
NP Adviser Name
If you have more than one newspaper/newsmagazine adviser, please enter them at end.
Your answer
NP Adviser Email
Your answer
NP Adviser Phone
Your answer
NP Adviser Cell Phone
Your answer
TV Broadcast (TV B) Information
Please leave blank any questions that do not apply.
TV B Name
Your answer
TV B Channel
Your answer
TV B Web Address
If online is the television broadcasts, please include a URL here. If the website provides readers with unique content online, please add Online as a publication below, and pay the membership fee for that publication.
Your answer
TV B Facebook Handle
Your answer
TV B Twitter Handle
Your answer
TV B Instagram Handle
Your answer
Other TV B Social Media
Please list name & handle.
Your answer
TV B Adviser Name
If you have more than one TV broadcast adviser, please enter them at end.
Your answer
TV B Adviser Email
Your answer
TV B Adviser Phone
Your answer
TV B Adviser Cell Phone
Your answer
Radio Broadcast (Radio B) Information
Please leave blank any questions that do not apply.
Radio B Name
Your answer
Radio B Channel
Your answer
Radio B Web Address
If online content is the radio broadcasts, please include a URL here. If the website provides readers with unique content online, please add Online as a publication below, and pay the membership fee for that publication.
Your answer
Radio B Facebook Handle
Your answer
Radio B Twitter Handle
Your answer
Radio B Instagram Handle
Your answer
Other Radio B Social Media
Please list name & handle.
Your answer
Radio B Adviser Name
If you have more than one radio broadcast adviser, please enter them at end.
Your answer
Radio B Adviser Email
Your answer
Radio B Adviser Phone
Your answer
Radio B Adviser Cell Phone
Your answer
Online News (ON) Information
Please leave blank any questions that do not apply.
ON Website Name
Your answer
ON Web Address (URL)
Your answer
ON Facebook Handle
Your answer
ON Twitter Handle
Your answer
ON Instagram Handle
Your answer
Other ON Social Media
Please list name & handle.
Your answer
ON Adviser Name
If you have more than one online adviser, please enter them at end.
Your answer
ON Adviser Email
Your answer
ON Adviser Phone
Your answer
ON Adviser Cell Phone
Your answer
Additional Adviser Information
If you have more than one adviser for any of the above, please enter them here.
Additional #1 Adviser Name
Your answer
What publication does he/she advise?
Check all that apply.
Additional Adviser #1 Email
Your answer
Additional Adviser #1 Phone
Your answer
Additional Adviser #1 Cell Phone
Your answer
MEMBERSHIP AND PAYMENT METHOD
$275 = Entire School (4+ publications/programs)
$225 = 3 publications/programs
$150 = 2 publications/programs
$75 = 1 publication/program
$40 Middle School/Junior High Membership
$100 Associate (Non Teacher individual or organization)
$0 Honorary (Retired from teaching)
Select Membership Type
Early Bird Discount?
I am renewing before Sept. 1! Please subtract $10 from my membership fees!
JEA Membership $60 per adviser
Please renew your JEA membership here. MIPA will receive $5 for each membership. $60 per year for 1, 2, 3 or 4 years.
JEA Membership Adviser Name(s)
Please list the full name(s) of the advisers who are joining JEA.
Your answer
Donation to Student Press Law Center
SPLC does so much for scholastic press rights. Help support them now by donating any amount (list below).
Your answer
Late Fee
After Dec. 1
TOTAL AMOUNT DUE
Enter the total of your membership choices.
Your answer
Payment Options
Mentor Program
If you would like a mentor or would like to work with new advisers, sign up here: http://mipajournalism.com/resources/mentor-program/
Membership Submission
Please save/print the form BEFORE submitting in case you need a copy for purchase orders and records. Right click and choose print. Change your printer to PDF. Save the form.

If you are completing this online, please just hit the submit button and relax. You can also edit if needed.

If you are unable to submit your membership online, please email Stephanie Green at mipa@missouri.edu for assistance.

MIPA
Missouri School of Journalism
132 Neff Annex
Columbia, MO 65211-1200

If you have any questions or concerns, please email mipa@missouri.edu or call (573) 882-6031

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