SkillsUSA Membership Form

Name:

__________________________  ______________________________

Address:

_________________________________________________________

 

_________________________________________________________

Home Phone:

______-______-________

Cell Phone:

______-______-________

 

Are you in a Career/Technical Program?  Yes       No

if Yes, Check the Program you are in?
 Commercial Music
 Computer Science Networking
 Criminal Justice
 Culinary Arts
 Financial Services
 Graphic Design
 Nursing
 Office Technology
 Radiography
 Respiratory
   

______________________________________________________________________________

Signature

 
  After completing this form, sign and mail to: Academic Affairs Office
    Attention: Becky Warren
    200 South 14th
    Parsons, KS 67357
 
Include a check or money order made out to Labette Community College SkillsUSA for the amount listed below.
         Student Dues:  $13.00 (Student's Only)
Professional Dues:  $19.00 (Director/Faculty/Staff Only)