SCABSE Membership Form 2022
Credit Card
Date
*
-
Month
-
Day
Year
Date
Name
*
Mr.
Mrs.
Dr.
Ms.
Miss
Prefix
First Name
Last Name
Suffix
Email (personal)
*
example@example.com
Email (work)
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number (preferably cell phone)
*
Please enter a valid phone number.
School District
Please Select
Abbeville
Aiken
Allendale
Anderson 1
Anderson 2
Anderson 3
Anderson 4
Anderson 5
Bamberg 1
Bamberg 2
Barnwell 19
Barnwell 29
Barnwell 45
Beaufort
Berkeley
Calhoun
Charleston
Cherokee
Chester
Chesterfield
Clarendon 1
Clarendon 2
Clarendon 3
Colleton
Darlington
Dillon 3
Dillon 4
Dorchester 2
Dorchester 4
Edgefield
Fairfield
Florence 1
Florence 2
Florence 3
Florence 4
Florence 5
Georgetown
Greenville
Greenwood 50
Greenwood 51
Greenwood 52
Hampton 1
Hampton 2
Horry
Jasper
Kershaw
Lancaster
Laurens 55
Laurens 56
Lee
Lexington 1
Lexington 2
Lexington 3
Lexington 4
Lexington/Richland 5
McCormick
Marion
Marlboro
Newberry
Oconee
Orangeburg
Pickens
Richland 1
Richland 2
Saluda
Spartanburg 1
Spartanburg 2
Spartanburg 3
Spartanburg 4
Spartanburg 5
Spartanburg 6
Spartanburg 7
Sumter
Union
Williamsburg
York 1
York 2
York 3
York 4
SC Public Charter School District
Charter Institute at Erskine
Other
What is the name of your organization if you are NOT part of school district?
My Products
*
Active Membership
Current Educators - Certified or Classified
$
40.00
Retired Membership
Retired from Educational Service
$
25.00
Affiliate Membership
Supporter of Education - Individual or Organization
$
40.00
Student Membership
High School or College Student - Not Employed by a School District
$
15.00
Pay with Credit Card
Debit or Credit Card
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
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submit
the form.
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