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Cape & Islands School Counselor Association Membership Application
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* Indicates required question
Please type your name
*
Your answer
Title
Your answer
School Name
Your answer
Address
*
Your answer
Work Phone Number
Your answer
Fax Number
Your answer
Personal Phone Number
*
Your answer
Email Address
*
Your answer
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
Your answer
Interns: please give the name of your current supervisor
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