Missouri NEA Student Program
Membership Application

Complete and mail with $13 annual dues to:

Missouri NEA Student Program
1810 East Elm Street
Jefferson City, MO 65101

Membership includes $2 million liability insurance.

Name:
 

Social Security Number:
 

College/University:
 

Mailing address at college/university:

 

Address to receive mail year-round:
 

 

 

E-mail address:
 

Phone:  (school)                                      (home)
 

Graduation date:
 
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Student member last year?          Yes                No
 

MNEA-SP 2002-03 annual dues: $13
Membership year is Sept. 1 - Aug. 31


Make check or money order payable to:
Missouri NEA Student Program