Registration

• Prefix/Title Dr. Mr. Ms.
• First Name
• Middle Initial
• Last Name
• Position
• District
• School
• Address
• City
• Zip Code
• Alt Phone
• Fax Number for Invoice
• E-Mail
• Payment Options Member: $125
  Non-Member: $225
  • Purchase Order #
  • Check # (Note: I've printed this form and mailed it with my check to KASSP, PO Box 46, Danville, KY 40423-0046)