Kansas City Suburban Elementary Principals’ Association

Membership Form

KCSEPA is an affiliate MAESP and NAESP that works to promote professionalism and collegiality
among school administrators. Active, aspiring, and retired principals are all encouraged to join
this incredible association. Feel free to copy this membership form to share with new and
aspiring principals in your district. Your annual association dues support a variety of activities
that recognize the importance of strong school leadership.

Please complete the information requested below and submit your check for dues to the name
and address listed below.

Name _____________________________________ Position ____________________________

District ____________________________________ School _____________________________

School E-mail Address__________________________________________________________

School Address _________________________________________________________________

School Phone# _____________________________ School Fax # ________________________

Cell # ___________________ School enrollment #__________ Grade Levels ____________

Member of MAESP: Yes _____ No ______ Member of NAESP: Yes ____ No _____

Please mail Membership Form and Dues to: *Active Principals: 2018-19 Annual Dues are $35
KCSEPA Treasurer Aspiring Principals: 2018-19 Annual Dues are $10
Kacey Johnson Retired Principals: 2018-19 Annual Dues are $10
4001 SW Christensen Road
Blue Springs, MO 64014
kjohnson1@bssd.net

Please make check payable to KCSEPA (no purchase orders)

District Check # ____________ Personal Check #: ____________ PayPal ________ kcsepa.weebly.com

Yes, I need a receipt _________

*Active Principal status refers to Building Principals, Assistant Principals, Administrative Interns & Direct