CCA-South: Membership Form

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THIS IS THE CCA-SOUTH MEMBERSHIP FORM.

FOR VIRTUAL MEETING ZOOM WEBINAR REGISTRATION FOR CCA SOUTH, LOOK FOR THE MEETING REGISTRATION PORTAL ON THE HOMEPAGE.
THANK YOU!! YOUR SUPPORT ALLOWS US TO INVITE SEVERAL SPEAKERS FOR EACH MEETING AND OFFER FREE or LOW COST PROGRAMMING AND EQUITABLE ACCESS.

First and last Name *

School or Organization Affiliation (if any)

Email Address *

Mailing Address *

The address above is my:

home address

school address

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Phone Number

IF paying for membership, do you want CCA-North Affiliation? *

Affiliation with CCA-North includes their emails about programming. For full Affiliated Membership, please choose $25 level for your CCA South membership payment.

Yes, I would like to be an affiliated member of CCA-North.

No, thank you.

PLEASE "SUBMIT" THIS FORM **AND** PLEASE REGISTER THROUGH THE WEBINAR LINK ! YOU WILL GET AN APPROVAL PLUS CONFIRMATION EMAILS. THANK YOU! PLEASE CONSIDER A DONATION OR MEMBERSHIP. (Regardless of Paypal description, your membership is always for the current academic year.)

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