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Suffolk Association for Continuing/Community Education

APPLICATION FOR MEMBERSHIP
2012

Please print this form, complete and send to the address below:

Name: _________________________________________

Position: ________________________________________

School/Agency Affiliation:_________________
Address:________________________________________

Business Telephone:_________ Home Telephone:___________

Home Address:_________________       E-mail: ___________

Type of Membership

Organizational*      $75.00                            
Administrator/Program Coordinator   $35.00                        
Teacher  $25.00                        
Retiree  $10.00                        


Please remit your dues via check, money order, or purchase order payable to SACCE.

Mail to:
SACCE Membership Secretary
c/o Western Suffolk BOCES
Career Center, Bldg. A
17 Westminster Avenue
Dix Hills, New York 11746


(631) 667-6000 x 327



Mark Your Calendar for the next Adult Learning Conference
October 15, 2011