Membership Application - ALACTE

ALACTE Membership Application

Membership dues are separate from Summer Conference registration fees. Membership is for one year.
PLEASE NOTE: ACTA Bylaws require that administrators join ALACTE/ACTA through the Council for Leaders in Alabama Schools (CLAS).

* Indicates required field

Name *

First

Last

Home Address *

Line 1

Line 2

City

State

Zip Code

Country

Membership Type *

ALACTE Membership Number - if you do not have one or cannot locate it, leave this field blank. ALACTE staff will assign numbers for new members and look up missing numbers for existing members after payment is received. *

ALACTE Program Area *

Home Email *

School Email *

Home Phone Number *

School Phone *

School Fax *

County of Employment *

School System *

School/Organization Address *

Line 1

Line 2

City

State

Zip Code

Country

LAST 4 Digits of Card - DO NOT ENTER the entire card number. This helps us avoid confusion by allowing us to compare registration forms with Square payments. Payment will be make on the next screen. *

Submit and Pay