Membership
Application
2020-2021
ASSOCIATION OF CALIFORNIA
SCHOOL ADMINISTRATORS
student
Here’s what’s in it for you!
n Weekly postings of administrative, supervisory, confidential job openings in EdCal and on ACSAs Web site.
n Timely news and practical information through EdCal, ACSAs weekly newspaper, and Leadership, the association’s professional
magazine, featuring articles by and for school administrators; periodic education research summaries.
n Up-to-the-minute email notifications on State and Federal budget issues that impact K-12 funding.
n Member rates on publications available through ACSAs Administrator’s Bookshelf.
n Member rates to attend ACSAs professional development programs, including the Leadership Summit.
n ACSA member benefits including group insurance plans and discount purchasing. For more information, please visit www.acsa.org
Connect with us!
Get connected to educational leaders across the state
through ACSAs myriad social media offerings or visit
us at www.acsa.org
ACSA student members receive:
Please detach and retain for your records.
$125 Dues for the July 2020 – June 2021 fiscal year.
Dues are prorated for members joining
after July 2020.
Check here if you wish to contribute $78 to ACSAs Political Action
Committee.
Contributions to support ACSA's political activities are not tax deductible.
ACSA retains sole discretion over use of member political contributions.
Dues may be deductible as business expenses. ACSA estimates that the
non-deductible portion of dues allocable to lobbying is 13.3 percent.
Check (full payment only)
Payroll deduction*
Signature
(required for payroll deduction)
I agree that my dues will be deducted by my payroll office. This
authorization shall be in effect until revoked by written notice from
myself or ACSA. I consent to the adjustment of such deduction to
reflect any change in the dues of which the payroll office may be
advised by the organization.
MasterCard/Visa (full payment only)
Card Number Exp. Date
Signature (required for credit card charge) Date
A change of employment designation to administrative or supervisory will
require a change to Regular membership.
Student members do not have voting privileges, and are not eligible to
serve as ACSA officers, directors, or committee members, nor are they
eligible for Professional Legal Services. Qualifying members may
remain in the Student category a maximum of four years. Beyond
that, a change in membership type and dues will result.
Educational administration program enrollment at an accredited California Higher
Education Institution.
Referred by (Please print one name only)
First Name M.I.
Last Name
Position/Title
Last Four Digits of Social Security Number
District
School
Address
City State ZIP
Work Phone Extension
Work Email Address
Personal Email Address (Required)
Check here if you do not wish to receive ACSA email at your work email
Address
City State ZIP
Home Phone Cell Phone
Opt-in to receive text messages from ACSA.
Preferred Mailing Address
Home
Work
Check here if you wish to view ACSA publications online only.
Date credential expected: _______________________________
( )
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2020-2021 dues
business
home
please enclose…
payment options
limitations
Please call ACSAs Member Services
Department at 650.692.4300 or
800.608.ACSA (2272)
Fax 650.437.9189
Email: memberservices@acsa.org
the path to
success
in educational
administration
begins at ACSA
ACSA offers special Student membership rates to
individuals who are enrolled in any education-related
graduate program leading to an administrative credential
at an accredited California institute of higher education.
(Individuals enrolled in coursework who are
designated as management or supervisory qualify for
Regular membership only.)
After completion of coursework, members securing
management or supervisory positions are elevated to
Regular membership with full benefits, including Member
Assistance and Legal Support Services.
not yet an administrator,
but completed your
coursework?
Associate membership is the category for you. Please call
ACSA at 800.608.ACSA (2272) or visit www.acsa.org for
more information.
( )
questions?
The information requested below will
remain confidential and will be used
for ACSA purposes only and will not
be sold to vendors or any third parties.
year of birth
__________________ Decline to State
gender orientation
Male Female LGBT
ethnicity
American Indian or
Alaska Native
Chinese
Japanese
Korean
Vietnamese
Asian Indian
Laotian
Cambodian
Other Asian
Hawaiian
Guamanian
Samoan
Other Pacific Islander
Filipino
Hispanic or Latino
African American, not
of Hispanic origin
White, not of
Hispanic origin
Decline to State
education level
Master’s Degree
Doctorate
Other
social media
Facebook
Instagram
Twitter handle: __________________________________
SRC: _______________
2020-2021 STUDENT MEMBERSHIP APPLICATION
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