Employment Information

First Name:	Last Name:
School Name:	School District:
Title/Position:

School Address (Line 1):

School Address (Line 2):

City:

State:

Zip Code:

Office Phone & Ext:	Email Address:
Office Fax:

Mailing Preference 
Select this option if you want mail sent to your school address.
Select this option if you want mail send to your home address.

Personal Information

Address (Line 1):

Address (Line 2):

City:

State:

Zip Code:

Home Phone:

PP ID# or SSN

Membership Selection*

*This program is open to anyone who is currently in an administrative/supervisory certification program (three-year limit). After three years, provided you are not an on-line principal, assistant principal or supervisor, you may continue your Aspiring Educational Leaders’ membership for $50 a year.

Available immediately upon activation: Newsletter, Educational Magazine, Member’s Handbook, Professional Development Opportunities (at member cost), Annual State Conference (at member cost), Legislative Updates, Counseling by Veteran Administrators, Networking Opportunities, etc. (Legal aid is NOT available to Aspiring Educational Leader members)

PAESSP Aspiring Educational Leader (In a 3-year Program) - ELEMENTARY $25
PAESSP Aspiring Educational Leader (In a 3-year Program) - SECONDARY $25
PAESSP Aspiring Educational Leader - After Three Years (IF YOU ARE NOT A PRACTICING PRINCIPAL) - ELEMENTARY $50
PAESSP Aspiring Educational Leader - After Three Years (IF YOU ARE NOT A PRACTICING PRINCIPAL) - SECONDARY $50
PAESSP & NAESP (Elementary) $475
Pennsylvania Association of Elementary and Secondary School Principals & National Association of Elementary School Principals
PAESSP & NASSP (Secondary) $475
Pennsylvania Association of Elementary and Secondary School Principals & National Association of Secondary School Principals

Payment Options*

Personal Check (After submission, please mail first check.)
* Membership will not be activated until PAESSP has received the check.
Personal or School District Check
(After submission, please mail check.)
School District Purchase Order
For immediate processing, include P.O. information below. Otherwise, mail P.O.
Installment Plan ($95 for 5 months)
(After submission, please mail first check.)
Payroll Deductions (See Business Manager)
(Prior to submission, please see business manager to enroll.)

I understand that my membership will not be activated until payment is received.

PAESSP Membership
122 Valley Road, P.O. Box 39
Summerdale, PA 17093