2020-2021 Brazos Valley Alliance of Black School Educators Membership Form

We need ALL hands on deck! Are you ready to give back to our academic community? Are you ready to make an impact in the academic success of our students? Are you ready to be a part of the legacy of our next generation? Great! JOIN US!
PERSONAL INFORMATION
Last Name *
First Name *
Address *
(Street, State, and Zip Code)
Personal Email Address *
Home Phone # *
Birthdate *
MM
/
DD
/
YYYY
SCHOOL/EMPLOYMENT INFORMATION
School District *
Name of School (If you are a college student, tell the college/university you attend. If you are a parent/guardian, tell what school(s) your child(ren) attend. *
Work Email Address *
Work Phone # *
Cell Phone #
(Do not answer if same as home #)
MEMBERSHIP INFORMATION
New or Returning Member *
Membership Type (Each level includes local (BVABSE) and state (TABSE) membership except the Parent/Community Member level) *
***Membership Payment Plan Option***
If you would like to pay your dues in 2 or 3 installments, go to the following link:
https://forms.gle/JAovEvMkLDusAcxx6
Installment payments:
Professional: 3 payments of $30
Paraprofessional: 2 payments of $15 and 1 payment of $10
Retired: 2 payments of $15 an1 payment of $20
College Student: 2 payments of $12 and 1 payment of $11
Parent/Community Member: 3 payments of $5
High School: 2 payments of $5
How would you like to pay the membership fee? *
Thank you so much for joining BVABSE!
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