1.
Registration Information
_____ New Membership _____ Renewal Membership
Charter
School Annual Membership
(please
check one)
____ For
charter schools with enrollment of 100 or lower, membership
is $200.
(For first year CANEC members dues
are $100.)
____ For
charter schools with enrollment of 101 or more, membership
is $3 per
student enrolled. Our school
has _____ students enrolled.
(For first year CANEC members dues
are $1 per student.)
____ Charter
School Development Group Annual Membership - $100
____ Charter
School Employee
Annual Membership
(please request membership form
from CANEC Office or click here for information on-line)
____ Charter
School Parents and Students Annual Membership - $40
* This membership category does
not include conference and workshop discounts.
____ Educational
Organizations Annual Membership - $350
(including school districts, county
offices of education and education associations)
____ Business/Industry Associate Membership - $500
____ Supporter
Annual Membership - $100. Suppoerter memberships available
ONLY to individuals
if they or their organization are not eligible for
any other CANEC membership.
2.
Member Information
Name:
________________________________________________________________________
School/Organization:
__________________________________________________________
Title:
_________________________________________________________________________
Address:
______________________________________________________________________
City:
_______________________________ County: __________ State: ______ Zip: ______
Telephone:
(_______)_____________________ Fax: (_______)________________________
E-mail:
________________________________________________________________________
(Yes,
please subscribe me to CANEC's Email list_____; No thank you_____)
3.
Payment Method
_____
Check enclosed
_____
Purchase order
_____
Credit Card. (Credit Cards other than Visa and MasterCard NOT accepted.)
Type:
_____ Visa _____ MasterCard
Account
#: _______________________________________________________
Print
name as it appears on card: __________________________________
Signature
of cardholder:___________________________________________
_____
Bill me
4. Please
accept $_____ donation (tax deductible) to support CANEC's programs.