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NCPSMA is accepting dues for the 2010-2011 membership year. Please print this page and mail with your dues payment ($20) to NCPSMA, 630 Adams Ridge Road, State Road, NC 28676-9536 Name_________________________________________________________ (Individual memberships only- NO company-wide memberships accepted) Address_______________________________________________________ City _____________________________ State ___________ Zip _________ Telephone ________________________ Fax _________________________ *School System Name (LEA) ______________________________________ **OR Company Name (Vendors)______________________________________ ***Membership Type _____ Regular _____ Retired _____ Vendor ________ Associate * Please list the name of your school system-Example: Alexander County Schools **If not an employee of a school system list your company or group name on the next line- Example: Company as B &D Boilers or Associate as DPI Plant Operation.
** Regular is someone currently employed in the maintenance department of a NC Public School System, Retired is someone retired from the maintenance department of a NC Public School System, Vendor is a company or manufacturer representative, Associate is everyone else. |