Diversity Council Membership Application

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Membership - Action to be Taken *

New Membership

Membership Renewal

Select your designated membership category: *

School District — $300.00

Charter/Private School/Independent — $300.00

Community Organization — $300.00

Location Name (Complete Official Name) *

Primary Contact (Name, Email, Telephone Number) *

Alternate Representative (Name, Email, Telephone Number) *

Principal/Supervisor (Name, Email, Telephone Number) *

Superintendent/Supervisor (Name, Email, Telephone Number) *

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