Copy and Print the form below, Fax or Email or Mail and send to:
Bev Bradford
IMLA Executive Director
P.O. Box 190869
Boise, ID 83719-0869
FAX 1-866-729-4861
bev.bradford@gmail.com

Download the PDF form.
Membership Form
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IDAHO MIDDLE LEVEL ASSOCIATION
MEMBERSHIP
JULY 1, 2009 – JUNE 30, 2010
   
__________________________________    __________________________________
Principal’s/Individual’s Name                             Principal’s e-mail address

__________________________________    __________________________________
School Building Name                                        School Telephone

__________________________________    __________________________________
School Mailing Address                                     City, State, Zip Code

IMLA Building Teacher Liaison:__________________________________

Liaison’s e-mail address:  _______________________________________

Region: (Please circle)   I           II          III        IV        V         VI

Dues Category based on numbers in State School Directory.

________ 1 Individual……………………$50.00 for an Individual Membership

________ 25 or fewer staff members …$125.00 for a Building Membership

________26-50 staff members …………$200.00 for a Building Membership

________51 or more staff members……$250.00 for a Building Membership

MAKE CHECKS/PURCHASE ORDERS PAYABLE TO IMLA AND MAIL TO:
IMLA
P.O. BOX 190869
BOISE, ID 83719-0869

FOR MORE INFORMATION CONTACT:
BEV BRADFORD, EXECUTIVE DIRECTOR
   208-484-5498
FAX 1-866-729-4861
bev.bradford@gmail.com