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WSCA Membership Application 2024 - 2025
July 1, 2024 - June 30, 2025
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* Indicates required question
Last Name
*
Your answer
First Name
*
Your answer
School/Agency
*
Your answer
Current Position
*
Your answer
Home or Business Address
*
Home
Business
Street Address
*
Your answer
City
*
Your answer
State
*
Your answer
Zip
*
Your answer
If you added your home address, do you want this published in our e-directory?
*
Yes
No
I selected my business address
Work Number
Your answer
Personal Number
Your answer
Email Address
*
Please use a personal email address as to not block WSCA emails from coming through to your work email!
Your answer
Work Setting
Elementary
Middle School
Junior High School
High School
College/University
Mental Health Agency
Graduate Student/Intern
Private Counselor
Clear selection
Membership Classification
*
Regular - $25
Student - $20
Retiree - $20
Lifetime Member - Free (Must be a current member that was voted into the Lifetime Membership)
I won a free membership during 2023-2024 year
Payment Method
*
Check (Payable to WSCA) Send to P.O Box 100, Commack, NY 11725
PO (Payable to WSCA) Send to P.O Box 100, Commack, NY 11725
Venmo (Memo: 2024-2025 WSCA Membership)
Lifetime Member - Free
I won a free membership during 2023-2024 year
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