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Individual Application Form
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* Indicates required question
Are you currently a member of the National AOSA?
*
If "YES," forward your AOSA receipt to Diana Alvarez (
iccaosatreasurer@gmail.com
)
Yes
No
Name
*
Your answer
Mailing Address (include city, state, and zip)
*
Your answer
Current School District (If Applicable)
*
If you do not belong as a member of a school district, type "NA"
Your answer
Work Email
*
Your answer
Phone (Best Contact Number)
*
By adding your number, you will receive updates via Remind to help keep you informed. You may opt out of this service at any time.
Your answer
Do you give your permission to photo/video record your image at workshops?
*
Yes
No
Select your ICCAOSA Membership:
*
Individual - $45
Individual with AOSA Membership - $19
Individual Workshop Only - $25
District - $299
Joint Chapter - $10
If applying as "Joint Chapter," indicate the name of the other chapter (this section is not required if not applicable)
Your answer
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