To update records, this form must be completed each year even if you have a multi-year membership.
You must complete a separate form for each publication.
DIRECTIONS:
Use the tab key or your mouse to move among questions. Do not use the "Return" key! When finished, click on the "Submit Form" button at the bottom of the page. If you inadvertently submit the form before you are finished, use the "Back" button on your browser to return to your form. Continue with all forms until you receive a printable INVOICE. A copy of the invoice must accompany the check. Please be sure to communicate this requirement to your school or district bookkeeper, so your check can be appropriately deposited. If you need to complete this form for another publication, a link back to this form will be at the bottom of the the Invoice.
Use the tab key or your mouse to move among questions. Do not use the "Return" key!
When finished, click on the "Submit Form" button at the bottom of the page.
If you inadvertently submit the form before you are finished, use the "Back" button on your browser to return to your form. Continue with all forms until you receive a printable INVOICE. A copy of the invoice must accompany the check. Please be sure to communicate this requirement to your school or district bookkeeper, so your check can be appropriately deposited.
If you need to complete this form for another publication, a link back to this form will be at the bottom of the the Invoice.
Publication Type: Broadcast Lit. Magazine Newspaper Newsmagazine Online Media Yearbook Publication Name How is this publication produced? During a class Extra-curricular If during a class, what is the name of the class? Number of members on this year's staff Website
Publication Type: Broadcast Lit. Magazine Newspaper Newsmagazine Online Media Yearbook
Publication Name
How is this publication produced? During a class Extra-curricular
If during a class, what is the name of the class?
Number of members on this year's staff
Website
School Information
School name School address: City Zip County Principal What grades are represented? School/Staff phone School/Staff Fax
School name
School address:
City Zip
County
Principal
What grades are represented?
School/Staff phone School/Staff Fax
Adviser Information
Adviser Adviser's home address City State Zip Adviser's home phone number (for emergencies only) Adviser's email address Subject adviser's teaching degree is in Number of years advising this publication Total number of years advising as of June 30, 2011 List other journalism classes (or journalism-related) you teach by NAME and NUMBER of students in each class Example: Journalism I, 20 1. 2. 3. 4.
Adviser
Adviser's home address
City State Zip
Adviser's home phone number (for emergencies only)
Adviser's email address
Subject adviser's teaching degree is in
Number of years advising this publication
Total number of years advising as of June 30, 2011
List other journalism classes (or journalism-related) you teach by NAME and NUMBER of students in each class Example: Journalism I, 20
1. 2. 3. 4.
Editor/Producer Information
Name Home address City State Zip Editor's email address
Name
Home address
Editor's email address
Membership Information (select one)
1-year high school student membership (2011-2012) - $20 1-year membership (2011-2012) - $40 1-year middle school student membership (2011-2012) - $10 3-year membership (2009-2012) - Paid 3-year membership (2010-2013) - Paid 3-year membership (2011-2014) - $100 1-year associate membership (2011-2012) - $50 Were you given a membership certificate by an SCSPA member, which is valid for a free one-year membership to SCSPA? yes no If yes, who gave you the membership certificate?
Evaluation Information (select one)
I would like an evaluation - $40 I do not need an evaluation - $0
Additional Services - Select all that apply.
Excellence in Scholastic Newspaper Awards Competition: ESNA Fall & Spring - $60 ESNA Fall Only - $30 ESNA Spring Only - $30 Individual Competitions: Broadcast Individual Competition - $25 Magazine Individual Competition - $25 Yearbook Individual Competition - $25 Mini-Evaluations: Newspaper mini-evaluation - $20 Annotation: (for publication evaluation) I would not like annotation - $0 I would like annotation for my publication - $30
Excellence in Scholastic Newspaper Awards Competition:
ESNA Fall & Spring - $60 ESNA Fall Only - $30 ESNA Spring Only - $30
Individual Competitions:
Broadcast Individual Competition - $25 Magazine Individual Competition - $25 Yearbook Individual Competition - $25
Mini-Evaluations:
Newspaper mini-evaluation - $20
Annotation: (for publication evaluation)
I would not like annotation - $0 I would like annotation for my publication - $30
How did you hear about SCSPA?
Adviser Brochure Principal Website
If you found out about SCSPA from another adviser please tell us his or her name:
Comments/Questions
Do you have a question about SCSPA or this membership/evaluation form? Do you know your Purchase Order number? If so, please use the box below to ask a question or provide any comments or information to the SCSPA office. You will be contacted by SCSPA staff, who will assist you with changes or additions to this application.
