NHSA at LDTA Membership Application

NHSDA at LDTA Membership Application

To apply for membership please complete all questions.
Name

First NameLast Name
E-mail
Birthdate

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Grade in school (2020-21)
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
LDTA Placement
Phone Number
Format: (000) 000-0000.
Upload current grade report

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Membership Type
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Junior Membership (6th, 7th, 8th grades)Free

Secondary Membership (9th-12th grades)Free
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NHSDA at LDTA Membership Application