Missouri AHEAD Membership Registration 2021

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Please complete the form below to submit your registration for membership to MO AHEAD 2021. Your registration is not complete until payment is received. Checks may be mailed to Attn: Becca Terry, 518 Hitt St, Memorial Union S5, Columbia, Mo 65211. If you choose the PayPal option for fee payment, you will receive an invoice from PayPal at the email address listed below within 2 business days.

All MO AHEAD memberships runs from January 1 – December 31. Membership expires December 31st regardless of when in the year they are renewed. Information concerning membership can be found at https://moahead.org/membership-information/.

2021 Renewal Deadline: March 1, 2021

Email *

Name (First and Last) *

Job Title *

Institution/Employer *

Phone *

Membership Type (select one) *

Postsecondary Professional ($30): This member is involved in the coordination or provision of services at a postsecondary educational institution working to enhance postsecondary educational opportunities for students with disabilities.

Associate Professional ($30): This member is working in a professional setting other than a postsecondary educational institution with an interest in enhancing educational opportunities for students with disabilities.

Professional Emeritus ($20): This member is no longer working in higher education and disability.

Student/Pre-Professional ($10): This member is enrolled in a postsecondary educational program and has an interest in enhancing educational opportunities for students with disabilities.

Member of a Nonprofit Agency ($50): This member belongs to a non-profit organized entity.

Member of a For-Profit Agency ($100): This member belongs to a for-profit organized entity.

Membership Fee Payment *

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Pay via PayPal

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