South Carolina Alliance of Black School Educators

SCABSE Membership Application

(fill in and the print out)

 Sir Name: Mr. Ms. Mrs. Dr.

 Name:

 Current Position:

 Business Address:
                                  

 School District:

 Home Address:
                            

 Email Address:

 Phone Number: (Home):
                        (Business):

 Mail to:        Home             Business

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Membership Recommendations

 Name:    
 Address:
                 

 Name:    
 Address:
                 

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Membership Fees

Active    ($40.00)
Affiliate  ($40.00)
Retired  ($25.00)
Student  ($10.00)

New
Renewal

Recruited by:

Make checks Payable to SCABSE

Print out and Mail to:
SCABSE, PO Box 11737, Columbia, SC  29211