Membership Application and Professional Dues Statement 2009-2010

To submit your completed MASA membership application form, you can mail it to MASA at 3550 Amazonas Drive, Jefferson City, MO 65109, or fax it to 573-556-6270. Alternatively, you may choose to include payment with the form and submit via the provided methods. Ensure you retain a copy for your records. For any questions or further assistance, contact MASA directly at the provided address or fax number.

For the 2024-2025 membership year, the important dates to remember are July 1, 2024, as the start date for the membership period and June 30, 2025, as the end date. Ensure that your application is submitted before the start of the membership period for timely processing.

The purpose of this form is to facilitate the application for active membership and the calculation of professional dues for the Missouri Association of School Administrators (MASA) for the 2009-2010 membership year. It also allows school districts to enroll additional central office members and designate a voting member for MASA meetings. Additionally, this form provides the option to join the American Association of School Administrators (AASA) alongside MASA membership.

• 1. Name: Enter your full name as the applicant.
• 2. Position: Specify your current position within the school district.
• 3. School District: Provide the name of your school district.
• 4. School Address: Enter the address of your school.
• 5. City: Provide the city where your school is located.
• 6. State: Enter the state where your school is located.
• 7. ZIP: Provide the ZIP code for your school's address.
• 8. School Phone: Enter the phone number for your school.
• 9. School Fax: Provide the fax number for your school.
• 10. Email: Enter your email address for communication purposes.
• 11. Years in current position: Specify how many years you have been in your current position.
• 12. Total years as Superintendent: Enter the total number of years you have served as a superintendent.
• 13. Total years as Assist. Sup./Director: Provide the total years you have served as an assistant superintendent or director.
• 14. Principal: Indicate if you hold a principal position.
• 15. Active Dues: Calculate and enter your active dues based on your 2009-2010 salary.
• 16. District Membership: Provide information for district membership if applicable.
• 17. Voting Member Name: Enter the name of the designated voting member for the district.
• 18. District Dues: Calculate and enter the district dues equal to the active membership fee.
• 19. Other district members: List additional district members and their email addresses.
• 20. Method of Payment: Specify your method of payment and provide necessary details.

Failure to submit this form may result in a lack of membership and representation within MASA.

• Loss of Membership: You will not be recognized as a member of MASA.
• No Voting Rights: You will not have the right to vote in MASA meetings.
• Missed Opportunities: You may miss out on professional development and networking opportunities offered by MASA.

• 1. New Membership: If you are applying for MASA membership for the first time.
• 2. Membership Renewal: If you are renewing your existing MASA membership.
• 3. District Membership: If your school district is applying for district membership with additional central office members.
• 4. AASA Membership: If you are joining the American Association of School Administrators (AASA) along with MASA.