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Membership Application
2008-09
Name (school/org):
_____________________________________________________________
Address:
______________________________________________________________________
______________________________________________________________________________
Phone:
_______________________________________________________________________
Administrator__________________________________________________________________
Business
Manager_______________________________________________________________
Development
Coordinator_________________________________________________________
Board
President_________________________________________________________________
Parent Council
President__________________________________________________________
Year
Established__________________________ Number
of Grades_____________________
Number of
Students_______________________
Membership Level Amount
Enclosed
Individual $100-$250 $_____________
Organization/Business $250 - $1,000 $_____________
Forming Schools/Initiatives $250-$500 $_____________
Schools - $5 - $10 per student
_____
students @ $____/each = $_____________
Please mail payment to the:
Alliance for Public Waldorf
Education
PO Box 2452
Fair Oaks, CA 95628
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Members 
