Southeastern District Association Membership Information Form
Director Name: *
Your answer
Email Address: *
Your answer
Name of School (No Acronyms): If there are two directors at your school, place your last name after the school name. Example: John F. Kennedy High School: Holland *
Your answer
School Address: *
Your answer
City: *
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Zip: *
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School Phone: *
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Cell Phone: *
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Home Phone:
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If you teach at a second school please complete the following.
Leave blank if you do not teach at a second school.
Name of Second School:
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School Address of Second School:
Your answer
City of Second School:
Your answer
Zip of Second School
Your answer
Phone of Second School:
Your answer
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