100% Middle Level Request Form
Please fill out this form if you would like to take part in the 100% Middle Level Affiliation package that is offered this year. Please answer all questions honestly and completely. 

Please note: there was a mistake in the original announcement of this membership package. This package was announced at $80, that is incorrect. This package will actually be $320. I apologize for any inconvenience or confusion this has caused. 
-Bethany Leonard, FCCLA State Adviser

If you have any questions please call or email the State Office. 
Thank you!
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Email *
Chapter Name *
Chapter Type *
What grades are the students in your building? *
Required
What grades do YOU teach? *
Required
How many students would you be affiliating with this package? *
Have you utilized this package in the past? *
Let us know why you would like to utilize this membership package? *
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