First Name of Applicant: — Required
Last Name of Applicant: — Required
Title: — Required
Business/School Name:
Business/School Address:
Business/School Address 2:
Business/School City:
Business/School State:
Business/School Zip:
Business/School Phone:
Website:
Email: — Required
Mobile Phone:
Home Phone:
Home Address:
Home Address 2:
Home City:
Home State:
Home Zip:
Spouses First Name:
Are You A Member of The GCSAA?
Yes No
GCSAA Membership Class:
GCSAA Membership Number:
WGCSA Membership Class you are applying for: — Required
Select Class AA - Lifetime Retired Member Class A - Supt. Member Class SM - Supt. Member Class C - Assistant Supt. Member Class D - Associate Member Class E - Affiliate Member Class H - Honorary Member Class I - Inactive Member Class R - Retired Member Class S - Student Member
Current Position:
Past positions held (Prior to current employment):
Please provide names of two WGCSA Members that can verify the above information(Class E Applicants can skip this) — Required
Important Instructions
Membership Classifications Class AA - Lifetime Retired Member (No cost if approved) Class A - Supt. Member ($150.00) Class SM - Supt. Member ($150.00) Class C - Assistant Supt. Member ($150.00) Class D - Associate Member ($150.00) Class E - Affiliate Member ($250.00) Class H - Honorary Member (No cost if approved) Class I - Inactive Member (No cost if approved) Class R - Retired Member ($75.00) Class S - Student Member (No cost if approved)