DASA Membership Application
DASA Membership Application
* Required
Title
*
Mrs.
Ms.
Mr.
Dr.
Other:
First Name
*
Your answer
Last Name
*
Your answer
Education Agency
*
Choose
Appoquinimink
Brandywine
Caesar Rodney
Cape Henlopen
Capital
Christina
Colonial
Delmar
Indian River
Lake Forest
Laurel
Milford
New Castle County VT
Polytech
Red Clay Consolidated
Seaford
Smyrna
Sussex Tech
Woodbridge
Department of Education
Charter School
Private School
School Name/Agency Department
*
Your answer
Position
Assistant or Associate Principal
Assistant Superintendent
Buildings and Grounds Admin
Chief Financial Officer
Chief School Officer/Superintendent
Curriculum and Instruction Admin
Principal
School Leader/Head of School
School Nutrition Services Admin
School Personnel/Human Resources Admin
Special Education/Programs Admin
Student Support Services Admin
Transportation Admin
Other:
Clear selection
Business Address (include number & street, city, state, zip code)
*
Your answer
Office Phone
*
Your answer
Cell Phone
Your answer
Email Address (District or Charter email preferred)
*
Your answer
Home Address (include number & street, city, state, zip code)
*
Your answer
DASA Membership ($355) is Required for Department Membership. Select the department you wish to join.
*
Delaware Association of School Business Officials ($5)
Delaware Association of School Personnel Administrators ($15)
Delaware Association of School Principals ($25)
Delaware Association of Curriculum and Instruction Supervisors ($5)
Delaware Chief School Officers Association ($50)
Delaware Association of Special Education Professionals ($25)
Delaware Child Nutrition Services Supervisors Association ($5)
AASA ($470)
NAESP ($235) if an Assistant Principal ($195)
NASSP ($250)
None of the above
Required
Enter Total Membership Dues Below ($355 plus department membership)
*
Your answer
With full knowledge of the above, I authorize my employer to deduct from my salary and pay to the association, in accordance with the agreed upon payroll deduction procedure, my association dues as may be determined from time to time as indicated above for the current membership year and each membership year thereafter, provided that I may revoke this authorization as of July 1 of any calendar year by giving written notice to that effect to DASA and my employer on or before June 30 of that year. Payment of Dues:
*
I authorize the above fees to be paid to DASA via payroll deduction (as indicated above).
I will be sending in a check payable to "DASA" to pay my dues.
Required
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