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LCCA 2023-2024 Membership Form
If you are completing this form, you must pay by PAYPAL. The QR code is at the bottom of this form.
If you would like to pay by check, please use the paper form
HERE
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Email
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Your email
Last Name
*
Your answer
First Name
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School or Agency
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Address
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Phone Number
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Do you have suggestions and/or topics for future workshops or activities?
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PayPal Option for Payment -
https://bit.ly/2NZaBeo
$30
for
counselors
and
$10
for
Students/Interns
). Registration is NON-REFUNDABLE. Thank you.
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I have paid by paypal
I will mail it with a check. *If selecting this PLEASE DO NOT SUBMIT THIS FORM*
I am Retired
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This form was created inside of Adlai E. Stevenson High School, District 125.
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