Demographic Information

Your answers to the following optional demographic questions will help MASCD better identify and serve our members.

1. __ Female    __ Male

2. __ Asian American

    __ African American

    __ Native American/First People

    __ Hispanic/Latin American

    __ White/Non-Hispanic

    __ Multi-Racial

    __ other (specify) ___________________________________________

3. Which of the following best describe your employment category?

    (Mark all that apply.)

    __ public school

    __ private school

    __ elementary

    __ secondary

    __ higher education

    __ teacher

    __ principal/assistant principal

    __ central office administrator

    __ student

    __ retired

    __ government

    __ other (specify) ___________________________________________

4. Are you currently a member of ASCD?  ‚ Yes   ‚ No

    If yes, how long?

    Indicate your ASCD membership number:

    __ Membership Renewal—$30

    __ New Member—$30

    __ Full-Time Student Membership—$15

I would like more information about:

    __ submitting an article for the newsletter

    __ presenting workshops at conferences

    __ serving on the MASCD board

    __ serving on an MASCD committee

    __ other (specify) ___________________________________________