Registration Form
Name of School
*
Name of Librarian
*
Address of School
*
Street Address
Street Address Line 2
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Please Select
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State
Zip Code
Phone
*
Email
*
School Enrollment
*
School Year
*
2024-2025
NCSA member school?
*
Yes
No
Select one:
*
I want to register for membership.
I want to order extra supplies.
Select Membership(s):
*
Gallery Award (1st-3rd grade) - $26
Crown (4th-5th grade) - $26
Lamplighter (6th-8th grade) - $26
Select one:
*
I want to order extra supplies.
I am ready to checkout.
I'd like to order (Gallery):
Extra Sticker Set (10) - $5.50 each
Extra Seal Set (1 winner and 1 runner-up) - $8.50 each
Extra Seal (please specify in comments) - $6.50 each
Medal for participating students - $9.00 each
Comments about Gallery supplies (extra quantities, type of seal needed, etc.)
I'd like to order (Crown):
Extra Sticker Set (10) - $5.50 each
Extra Seal Set (1 winner and 1 runner-up) - $8.50 each
Extra Seal (please specify in comments) - $6.50 each
Medal for participating students - $9.00 each
Comments about Crown supplies (extra quantities, type of seal needed, etc.)
I'd like to order (Lamplighter):
Extra Sticker Set (10) - $5.50 each
Extra Seal Set (1 winner and 1 runner-up) - $8.50 each
Extra Seal (please specify in comments) - $6.50 each
Medal for participating students - $9.00 each
Comments about Lamplighter supplies ( extra quantities, type of seal needed, etc.)
My Products
*
Categories:
All
All
Memberships
Extra Supplies
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( X )
Memberships
Gallery Membership (K - 2nd Grades)
All memberships include: 1 Poster (10) Book Spine Stickers 1 Award Winner Seal Sticker 1 Award Runner-up Seal Sticker
$
26.00
Quantity
1
2
3
4
5
6
7
8
9
10
Crown Membership (3rd - 5th Grades)
All memberships include: 1 Poster (10) Book Spine Stickers 1 Award Winner Seal Sticker 1 Award Runner-up Seal Sticker
$
26.00
Quantity
1
2
3
4
5
6
7
8
9
10
Lamplighter Membership ( 6th - 8th Grade)
All memberships include: 1 Poster (10) Book Spine Stickers 1 Award Winner Seal Sticker 1 Award Runner-up Seal Sticker
$
26.00
Quantity
1
2
3
4
5
6
7
8
9
10
Extra Supplies
Crown - Extra Spine Stickers
Set of 10
$
5.50
Quantity
1
2
3
4
5
6
7
8
9
10
Gallery - Extra Spine Stickers
Set of 10
$
5.50
Quantity
1
2
3
4
5
6
7
8
9
10
Lamplighter - Extra Spine Stickers
Set of 10
$
5.50
Quantity
1
2
3
4
5
6
7
8
9
10
Gallery - Extra Seal Sticker Set
1 Gold Seal, 1 Silver Seal
$
8.50
Quantity
1
2
3
4
5
6
7
8
9
10
Crown - Extra Seal Sticker Set
1 Gold Seal, 1 Silver Seal
$
8.50
Quantity
1
2
3
4
5
6
7
8
9
10
Lamplighter - Extra Seal Sticker Set
1 Gold Seal, 1 Silver Seal
$
8.50
Quantity
1
2
3
4
5
6
7
8
9
10
Item subtotal:
$
0.00
Comments/Notes
I prefer to:
*
Pay by Check
Pay by Credit Card
I belong to a NSCA Member School and am not ordering any extra supplies. I will have no payment.
Submit
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