NAME

Avatar

Email *

Password*

Retype Password *

First Name *

Last Name *

School District, Agency or Organization *

Title *

Address *

City *

Zip *

State *

Phone *

Select the NAME Membership Category that describes you ($50.00 per person). If you are not sure which category best describes you, use the decision making tree found on the JOIN! page, under definitions. *

Local Education Agency (LEA)- An employee of a public board of education or other public authority legally constituted within a State for either administrative control or direction of, or to perform a service function for, public elementary schools or secondary schools in a city, county, township, school district, or other political subdivision of a State, or for a combination of school districts or counties as are recognized in a State as an administrative agency for its public elementary schools or secondary schools. This does not include vendors who are not directly employed by the LEA.

State Education Agency (SEA) - An employee of the State board of education or other agency or officer primarily responsible for the State supervision of public elementary schools and secondary schools, or, if there is no such officer or agency, an officer or agency designated by the Governor or by State law. This does not include vendors who are not directly employed by the SEA..

State Medicaid Agency (SMA) - An employee of a single State agency administering or supervising the administration of a State Medicaid plan. This does not include vendors who are not directly employed by the SMA.

Associate Membership - An employee of an agency/organization interested in or company that provides services/supports for school health, Special Education or Medicaid in Education, or functions as a Medicaid billing agent. Vendors of LEAs, SEAs, and SMAs are most often defined as an Associate Member.

NAME Regions (please select one) *

Region 1: Connecticut, Delaware, District of Columbia, Kentucky, Maryland, Massachusetts, Maine, New Hampshire, New Jersey, New York, North Carolina, Pennsylvania, Rhode Island, South Carolina, Tennessee, Vermont, Virginia, West Virginia

Region 2: Alabama, Arkansas, Florida, Georgia, Illinois, Indiana, Iowa, Louisiana, Michigan, Minnesota, Missouri, Ohio, Mississippi, Oklahoma, Texas, Puerto Rico, US Virgin Islands, Wisconsin

Region 3: Alaska, Arizona, California, Colorado, Hawaii, Idaho, Kansas, Montana, Nebraska, Nevada, New Mexico, North Dakota, Oregon, South Dakota, Utah, Washington, Wyoming

In order to improve networking within the NAME organization, we would like to publish a member directory, by region, on our members only website. If you would like to opt out of having your directory information included, click opt out below.

Opt Out

Price

$

Payment Method

Paypal

Credit Card Number*

Expiration Date*

/

Card (CVV) Code*

Card Holder Name*

I want to subscribe to your newsletters

Membership Subscription

Existing user? Please login

New User? Please register

Account Information

Payment Information