HML Appliation PDF Print E-mail
Written by Jack Mckay   
Friday, 02 October 2009 08:13

The Horace Mann League of the USA  

Membership Application Form


The Horace Mann League exists to:

 

1. Perpetuate the ideals of Horace Mann.

2. Preserve and support quality public schools.

3. Preserve the separation of church and state. 

 



Mr. Mrs. Ms. Dr. _________________________________________________

Address ________________________________________________________

City ______________________ State _____ Zip _______________________

Work Phone ( ) _____ _________ FAX ( ) _____ _____________

Internet e-mail ______________________ @ ___________________________

Position _________________________________________________________

Your highest degree was earned at (Name of university)____________________

Nominated by (optional) _____________________________________

Annual Dues: $65.00 (Federal ID: 52-6054490)

Make check to:
The Horace Mann League of the USA
560 Rainier Lane
Port Ludlow, WA 98365

 


If payment by credit card: American Express __ , Master Card __ , or Visa __.

 

Account No. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Exp. Date ____

Signature required ___________________Phone (_ _ _) __ __ __-__ __ __ __

 


Mail to: The Horace Mann League of the USA
Dr. Jack McKay, Executive Director
560 Rainier Lane
Port Ludlow, WA 98365

Email: This e-mail address is being protected from spambots. You need JavaScript enabled to view it

FAX (866) 389 0740
Phone (360) 437 1186


 

 

 

Last Updated on Friday, 02 October 2009 08:22