VIEWS: 4 PAGES: 1 POSTED ON: 6/22/2011
NATIONAL CATHOLIC EDUCATIONAL ASSOCIATION 1005 N. Glebe Road, Suite 525 • Arlington, VA 22201 800.711.6232 • Fax: 703.243.0025 2011 MEMBERSHIP APPLICATION FOR EARLY CHILDHOOD CENTERS ❑ Yes, enroll our early childhood center as an institutional member of the National Catholic Educational Association. Mail all publications to which our school is entitled to me, as director/administrator, at the following address: CENTER’S NAME:__________________________________________________________________________________________ DIRECTOR/ADMINISTRATOR:________________________________________________________________________________ Prefix Preferred First Name MI Last Suffix Community or Degree ADDRESS:__________________________________________________________________________________________________ CITY:_______________________________________________________ STATE:___________ZIP:_______________-__________ COuNTRY:__________________________________________________________________________________________________ PHONE:____________________________________________________ FAX:__________________________________________ E-MAIl ADDRESS (Internet format e.g.: email@example.com):_______________________________________________________ wEb SITE: http://www.______________________________________________________________________________________ ARCH/DIOCESE:____________________________________________________________________________________________ Membership in NCEA includes the following benefits: • Momentum, the award-winning academic journal • Elementary Newsletter and NCEA Notes • Member rates for registration for the NCEA meetings • Member rates for NCEA publications • Supplemental insurance eligibility sponsored through Trust for Insuring Educators • Tax-deferred annuity plan eligibility offered by Mutual of America • Discounts on rental cars available through Alamo, Hertz and National Car Rental • Preferred MasterCard® for qualifying members through bank of America Current enrollment includes: ❑ under three-year-olds ❑ Five-year-olds ❑ Eight-year-olds ❑ Three-year-olds ❑ Six-year-olds ❑ Four-year-olds ❑ Seven-year-olds _____ Total number of children served Membership Dues $155.00 Signature:____________________________________________ Membership Application Date ___________________ Please check payment method in U.S. Dollars: ❑ Check enclosed $_________________ ❑ Charge $__________________ to my: ❑ Visa ❑ MasterCard® ❑ AMEX Account Number________________________________________________ Expiration Date ___________________ Cardholder's Name_______________________________________________ billing Zip Code __________________ (please print name exactly as it appears on the card) Signature:_________________________________________________________________________________________
"NATIONAL CATHOLIC EDUCATIONAL ASSOCIATION"