Name *

Include first and last name

First Name

Last Name

School/Organization Address

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Address 2

City

State/Province

Zip/Postal Code

Country

Home Address

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City

State/Province

Zip/Postal Code

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Phone

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Membership status *

Are you a new or current member?

New

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Membership type *

Please select your membership type.

Regular MSELA Membership ($20)

Retired MSELA Membership ($10)

Corporate MSELA Membership ($50)

Dual MSELA/MAST Membership ($45)

Dual Retired MSELA/MAST Membership ($22.50)

Past President Membership (free)

Payment options *

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