Cape & Islands School Counselor Association Membership Application

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Title

School Name

Address *

Work Phone Number

Fax Number

Personal Phone Number *

Email Address *

Membership Type *

Professional Membership—licensed guidance, college, and independent counselors and official admissions representatives from public and private secondary and post-secondary schools, colleges and universities, employed in a full-time or part-time capacity ($25.00)

Associate Membership—licensed counselors who are not currently employed in the field, school/guidance counselor interns who are enrolled in a degree program leading towards licensure in school guidance and counseling ($20.00)

Honorary Life Membership—retired CISCA members (no fee)

New members: please indicate who has referred you to CISCA

Interns: please give the name of your current supervisor

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