HASLMS Membership Form 2019-20
You will receive an email confirmation after submitting this form. If submitting dues by check, print out the emailed form & send with check or money order to Sally Ehlke, Monroe MS, Rt. 1.
Email address *
Member Information
Name (First & Last) *
Your answer
School *
Your answer
Work Phone (plus extension) *
Your answer
School Mail Route *
Your answer
School Level *
Home Address (street, city & zip please)
Your answer
Home Phone (or Cell)
Your answer
I would like to be active in HASLMS this year by participating in the following:
Membership Dues
Membership Dues: $30.00 & New Media Specialists: $25.00 (Paypal will add $1.25 for processing fees if paid online.)
I will be submitting my dues via: *
A copy of your responses will be emailed to the address you provided.
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