JCASL Membership Form 2020-2021
Please be sure to fill in your Paypal email name, if you pay online. We can verify your payment and prevent confusion.
Email *
Last Name *
First Name *
School Name *
JCPS or Non-JCPS *
How many years have you been a JCASL member (counting this year)? Best guess is ok. *
Preferred Email *
Birthday (MM/DD)
School address
Zip code
School phone (xxx-xxx-xxxx)
Personal Phone Number (xxx-xxx-xxxx)
Home Street Address
Home City
Home Zip Code
Social Media info (Twitter/Instagram/Facebook that you would like to share)
If you would like JCASL to put in a good word for you at your school, please add their Twitter info below.
Membership Due Amounts *
Do you give JCASL permission to share your basic information on a shareable membership list with other JCASL members? (Name/school/email/social media) *
Never submit passwords through Google Forms.
This form was created inside of Jefferson County Public Schools. Report Abuse