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NMCSS Membership Form
Date: _____________________________________________________________
_____ New _____Renewal Name: _____________________________________________________________ Address: __________________________________________________________ City / State / Zip: ____________________________________________________ Phone Number: ____________________ E-Mail: ____________________________ Fax: _____________________________ Place of Employment: __________________
Work Number: ___________________
Address: _____________________________________________________________ City / State / Zip: ______________________________________________________
Current Job Description: (Courses
taught, grade level Etc.: __________________________________________________________________ __________________________________________________________________
Current
annual dues are $15.00, $5.00 for full time college students. Copy
and complete form. Makes
checks payable to NMCSS. Frances Garcia2827 Don Quixote Santa Fe, NM 87505
471-0408 (H)
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