Membership Renewal

School Name*
Member Name (Board Chair or Former Board Chair Name)*
Member Home Mailing Address*
City*
State*
Country*
Zip*
Preferred Phone*
- Home
- Work
- Mobile
Phone*
Email*
If you are adding the Chair Elect to your school's membership for an additional $100.00, please indicate name below.
Chair Elect email address
Billing Contact Information: Name*
Billing Contact Information: Email address*
Please indicate if there are any changes since last year for the following information*
- School Name
- Head of School name
- Head of School Email Address
- School Address
- School Website Address
- Nothing has changed
Updated School Name*
Updated Head of School name*
Updated Head of School Email Address*
Updated School Address*
Updated School Website Address*
How did you hear about ISCA?
How many years have you been serving as Board Chair?*

Please choose membership level*
Total
$0.00
Credit Card
Card Details
Cardholder Name
- I prefer to pay by check
*
- I give ISCA permission to share my contact information only with other ISCA members
Please enclose check payable to “ISCA” with this application form and mail to:

Ms. Bethany DiNapoli, Executive Director, ISCA
287 Gibbs Avenue
Newport, RI 02840