West Suburban School Counselor Association 2019-2020 Membership Application

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Debora Monteiro, Co-President Kerry Bartlett, Co-President
Milford High School Hudson High School
31 West Fountain St. Milford, MA 01757 69 Brigham Street, Hudson, MA 01749
(508) 473-1110 X2183 (978) 567-6250 X13119
dmonteiro@milfordma.com kabartlett@hudson.k12.ma.us

Counselors will be considered members after completion of this form AND submission of membership dues.

Annual Membership Dues: Professional - $20.00, Students - $15.00, Affiliates (members not certified by DESE) - $30, Retired members - No Fee
*Special Department Fee: 0-5 counselors $55, 5-10 counselors $100
*Special Pay-As-You-Go Professional membership Fee: $10 plus $5 per dinner fee on the day of a meeting

Dues are to be collected in cash either in person at a meeting or accompanying the registration form and mailed to:

WSSCA Treasurer, Rachel Erikson
Framingham High School
115 A Street, Framingham, MA 01701
rschmid@framingham.k12.ma.us

Retired members are welcome to stay on the WSSCA electronic correspondence list as there are no annual fees. Retirees will be placed on a first come, first serve basis if and when space is made available for dinner meetings. It is the responsibility of the retiree to contact WSSCA and notify us of your current contact information.

Last Name *

First Name *

E-mail address *

Institution *

City, State, Zip Code *

Work Phone Number

Work Setting Role *

Completed Years of Service *

Are you a new member to WSSCA this year? *

Yes

Do you give WSSCA permission to share you e-mail address with a college hosting one of our 2019-20 meetings? *

Yes

Are you a current member of MASCA? *

Yes

What type of WSSCA membership are you interested in? *

Professional Member ($20 Fee)

Student Member ($15 Fee)

Retired Member (No Fee)

Department Member ($50: 0-5 member, $100: 6-10 members)

Special Pay-as-you-go Member ($10, plus $5 every meeting)

Affiliate/Associate Member ($30)

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