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Join NCSSWA
- Membership Application |
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) __________
Student membership ($17.50) __________
Retired membership ($17.50) __________
Pay an additional $120.00 and become a SSWAA member ___________
Checks payable to NCSSWA
Send to:
Stephanie Minter, NCSSWA Treasurer
4 Mine Bluff
Court
Durham, NC 27713
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