Fillable President and Delegate 1 (Association of California School Administrators)

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President and Delegate 1 (Association of California School Administrators)

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2020/21 REGION OFFICERS
Email or mail to: Lori Allred
ACSA- E-Mail lallred@acsa.org
1029 J Street, Suite 500
Sacramento, CA 95814
20/2 REGION OFFICERS REGION ________
President and Delegate 1
Name: Social Security #:
Title: District:
School:
Address:
City/State/Zip:
Home Address:
Work phone: Work Fax Number:
Home phone: E-mail Address
Please check the appropriate box for affirmative action: Male Female
African/American Asian Caucasian
Eskimo-American Filipino Latino
Pacific Islander
2020/21 REGION OFFICERS
Email or mail to: Lori Allred
ACSA- E-Mail lallred@acsa.org
1029 J Street, Suite 500
Sacramento, CA 95814
20/2 REGION OFFICERS REGION ________
President-Elect and Delegate 2
Name: Social Security #:
Title: District:
School:
Address:
City/State/Zip:
Home Address:
Work phone: Work Fax Number:
Home phone: E-mail Address
Please check the appropriate box for affirmative action: Male Female
African/American Asian Caucasian
Eskimo-American Filipino Latino
Pacific Islander
2020/21 REGION OFFICERS
Email or mail to: Lori Allred
ACSA- E-Mail lallred@acsa.org
1029 J Street, Suite 500
Sacramento, CA 95814
20/2 REGION OFFICERS REGION ________
Vice President
Name: Social Security #:
Title: District:
School:
Address:
City/State/Zip:
Home Address:
Work phone: Work Fax Number:
Home phone: E-mail Address
Please check the appropriate box for affirmative action: Male Female
African/American Asian Caucasian
Eskimo-American Filipino Latino
Pacific Islander
2020/21 REGION OFFICERS
Email or mail to: Lori Allred
ACSA- E-Mail lallred@acsa.org
1029 J Street, Suite 500
Sacramento, CA 95814
20/2 REGION OFFICERS REGION ________
Vice President for Legislative Action and Delegate 3
Name: Social Security #:
Title: District:
School:
Address:
City/State/Zip:
Home Address:
Work phone: Work Fax Number:
Home phone: E-mail Address
Please check the appropriate box for affirmative action: Male Female
African/American Asian Caucasian
Eskimo-American Filipino Latino
Pacific Islander
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2020/21 REGION OFFICERS
Email or mail to: Lori Allred
ACSA- E-Mail lallred@acsa.org
1029 J Street, Suite 500
Sacramento, CA 95814
20/2 REGION OFFICERS REGION ________
Region Treasurer
Name: Social Security #:
Title: District:
School:
Address:
City/State/Zip:
Home Address:
Work phone: Work Fax Number:
Home phone: E-mail Address
Please check the appropriate box for affirmative action: Male Female
African/American Asian Caucasian
Eskimo-American Filipino Latino
Pacific Islander
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President and Delegate 1 (Association of California School Administrators)

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Completed 29 July 2020

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