2019 Annual Institutional Membership Application
Please provide the following information about your institution:
School Name *
Your answer
Mailing Address *
Your answer
City, State, Zip *
Your answer
Telephone Number *
Your answer
School's Web Address *
Your answer
Please indicate the total unduplicated headcount of full and part-time students enrolled in 2017-2018. This can be found on your 2018 FISAP, Part II, Section D, Line 7 A and B. *
Your answer
Amount Due *
Required
Indicate the name, title, telephone number, year MASFAA membership started, and email of ALL your staff members. *
Your answer
Submit appropriate payment amount by March 1, 2019. Please confirm with your A/P department that they have the correct person and school name on the check. We can provide a W4 to update this information, if needed. *
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If you need to print this form to submit a check request, please print before submitting it. Google Forms does not generate a submission page after you submit. *
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