MCEA | Membership Application

Membership Application

Minnesota Community Education Association
Membership Year: January 1 - December 31, 2012
Section I
District Information
District Name (Business Name) ISD Number Region Number District Population (used in levy calculation) Number of Full-time Staff Number of Part-time Staff
Section II
Director / Administrator Information
First Name Last Name Mailing Address City State Zip Code Work Phone Home Phone Fax Number E-Mail
Section III

A. District Membership

Your District Population	The Number of Memberships You Receive	Membership Dues
1 - 1,999	1	$76
2,000 - 4,999	3	$110
5,000 - 14,999	5	$485
15,000 - 29,999	7	$695
30,000 - 49,999	10	$1,035
50,000 - 99,999	13	$1,320
100,000+	17	$1,710
Based On Your District Population		$

Additional District Staff Members ($165 for unlimited*)	# $165	$
Advisory Council	# $100	$
Joint Literacy MN ($25 additional per person**)	# x $25	$
Joint MnSACA ($70 additional per person**)	# x $70	$
	Total District Membership	$

B. Non-District Membership Options

Not Selected	None
Community Educator not affiliated with a school district	$87	$
Citizen Membership (Retired and Students)	$35	$
Other Educational Institutions	$185	$
Business Partner	$425	$
Lifetime Membership (Retired)	$50	$
2nd Year Renewal ($50 first year, $5 renewal fee evry year therafter)	$50 (First Year) $5 (Renewal)	$
	Total Non-District Membership	$

MCEA Executive Office
13750 Lake Blvd., Lindstrom, MN 55045
ph: (651) 257-0752 | fax: (651) 213-2094

Membership Application