Associate Membership Join LIASEA Fee * Associate Membership - $ 500.00 Associate Individual Membership - $ 200.00 Total Amount I am paying membership for my Agency/Organization On Behalf Of Organization District Name * Email * District Name City Account Please enter a Username to create an account. If you already have an account please login before completing this form. Username * Check Availability Punctuation is not allowed in a Username with the exception of periods, hyphens and underscores. Your Registration Info First Name * Last Name * Job Title Click here to view a list of all current members and school districts Type Current Employer's name exactly as written in this list. Type 'None' if you are not part of a school district or company. Current Employer * Your Email Address * Support Staff Email Address Phone and Extension Payment Options Payment Method Credit Card I will send payment by purchase order or check. Review your contribution
