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Join NCSSWA
- Membership Application
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Name:
______________________________________
Home Address: ____________________________________________________________
Employer:____________________________________
School Address:____________________________________________________________
Home Phone:______________
Work Phone:______________
Email Address: ________________________________
Degree: _____________________________________
BSW:________ MSW: ________ Other: ___________
Membership year is from fall conference to fall conference.
Regular membership ($35.00) __________
OR
Student membership ($17.50) __________
OR
Retired membership ($17.50) __________
In Addition
If you are a member of
NCSSWA, and would like to join SSWAA, please enclose a
check in the amount of $95.00 written to SSWAA.
Our Association will forward your membership fee to
SSWAA.________________
Checks payable to NCSSWA
Send to:
Terry Scott, Treasurer
1102 Rauhut Street
Burlington, NC 27217
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Print
Application
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