Director Registration

Director Registration
Please complete the form below. Once you press submit, you will need to download the PDF invoice on the next page. Please print and submit that invoice with your payment to

MTVA
LeAnn Harris, Treasurer
P.O. Box 332454
Murfreesboro, TN 37133

Registration closes Sept. 7th. Printed invoice and payment must be received by September 14th.
Director Full Name*

PrefixFirst NameMiddle NameLast Name
Type of Membership*

Full (Active)Introductory (Active)RetiredCollegiate
NAfME #: *
Must be 9 numbers...include 0's at beginning. If you do not have a NAfME#, please put nine zero's.
Regional Association*

MTVAMTSBOAMTGMEA
MTSBOA Members joining MTVA, How are you paying your TMEA Fees?*

Through MTVAThrough MTSBOAThrough MTGMEA
Cell Phone*
Home E-Mail*

Confirmation Emailexample@example.com
Home Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Did you change schools between 2023-2024 and the 2024-2025 School Year?*

YesNo
School Phone*
School E-Mail*

Confirmation Emailexample@example.com
School Name*
No Abbreviations
School Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred E-Mail for MTVA Communications (Mailchimp)*

Confirmation EmailNote: Many school e-mails will block communications from Mailchimp. You can always change this address in the Directors Only Section of the website.
Do you currently teach in a Title I School?*
Not counting the 2024-2025 school year, how many total years of teaching experience do you have? *
Birth Month*
Birth Date*
Age Range*
Ethnicity (Check all that apply)*

AsianAmerican Indian or Alaska NativeBlack or African AmericanHispanic, Latinx, or Spanish OriginWhite or CaucasianMiddle Eastern or North AfricanNative Hawaiian or Other Pacific IslanderI prefer not to respondOther
Gender*
Fees to be Paid:*

$75 - Full Active Membership (TMEA/MTVA ($50/$25)$25 - Full Active Member that will pay TMEA Fees through MTSBOA$55 - Introductory Active MTVA Members (TMEA/MTVA ($30/$25)$15 - Collegiate Member (TMEA/MTVA ($15/$0)$50 - Retired Teacher NAfme/TMEA/MTVA ($25/$25)
Total Amount Due
You may not get an e-mail with this information based on your e-mail client's filters.

PLEASE DOWNLOAD PDF INVOICE ON THANKYOU PAGE ONCE YOU PRESS SUBMIT.
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