SHAPE NV Membership Form
Please complete this membership form August 2022-July 2023
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Email *
First and last name *
Mailing address where you want to receive mail from SHAPE NV *
Phone number *
I reside in:
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School district where employed *
School name or central office position *
What subject do you teach? *
What grade level do you teach? *
What is the name of you administrator? *
Administrators email address *
I am interested in becoming a SHAPE NV board member *
I understand the cost of regular membership is $35, Retired/Student membership is $10. 
Payment should be made via Venmo @ShapeNV or check payable to Shape NV c/o Erin Been 2877 Del Mar Drive Minden NV 89423.
I am registering as a: *
Method of Payment *
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