Department of Student Programs (DSP) Membership-Participation Form – Indiana Association of School Principals

- School Name*
- School Phone #*
- Name of Person Submitting this Form*
  
  First
  
  Last
- Email of Person Submitting this Form*
- Principal Name*
  If there is not a Principal in place at this time, please type “TBA” in both the first name and last name fields.
  
  Prefix
  
  First
  
  Last
- Principal Email*
  If there is not a Principal in place at this time, please type YOUR email address in this field so we know that information is reaching someone at the school.
- ECA Treasurer Name*
  If there is not a Treasurer in place at this time, please type “TBA” in both the first name and last name fields.
  
  Prefix
  
  First
  
  Last
- ECA Treasurer Email*
  If there is not a Treasurer in place at this time, please type YOUR email address in this field so we know that information is reaching someone at the school.
- Athletics Treasurer Name*
  If there is not a Treasurer in place at this time, please type “TBA” in both the first name and last name fields.
  
  Prefix
  
  First
  
  Last
- Athletics Treasurer Email*
  If there is not a Treasurer in place at this time, please type YOUR email address in this field so we know that information is reaching someone at the school.
- Corporation Treasurer Name*
  If there is not a Treasurer in place at this time, please type “TBA” in both the first name and last name fields.
  
  Prefix
  
  First
  
  Last
- Corporation Treasurer Email*
  If there is not a Treasurer in place at this time, please type YOUR email address in this field so we know that information is reaching someone at the school.
- FOR HIGH SCHOOLS ONLY: Information provided here will be used to contact school personnel regarding our Indiana Academic All-Stars and Rising Stars of Indiana programs.
- Guidance Department Contact Name 1
  
  Prefix
  
  First
  
  Last
- Guidance Department Contact Email Address 1
- Guidance Department Contact Name 2
  
  Prefix
  
  First
  
  Last
- Guidance Department Contact Email Address 2
- If you would like to have additional counselors/administrators receive information regarding these 2 programs, please email Diane Abel at dabel@iasp.org.
- School Address*
  
  Street Address
  
  City
  
  State
  
  ZIP Code
- Enrollment in each Grade Level Represented in School:
- K
- 1
- 2
- 3
- 4
- 5
- 6
- 7
- 8
- 9
- 10
- 11
- 12
- Total Enrollment
- Department of Student Programs Membership Fee
- Total Enrollment
- Elementary Membership
  Any building up through grade 6.
  - Elementary Membership: $55.00
- Middle Level Membership
  Any building up through grade 8.
  - Middle Level Membership: up to 350 total enrollment: $135
  - Middle Level Membership: 351+ total enrollment: $170
- Senior Level Membership
  Any building up through grade 12.
  - Senior Level Membership: up to 500 total enrollment: $225
  - Senior Level Membership: 501+ total enrollment: $345
Academic Competitions
- ELEMENTARY
- Register for Elementary Contests by making a selection in each box below.
- Register for Elementary Spell Bowl*
- Elementary Spell Bowl
  
  Price:
- Add Additional Elementary Spell Bowl Team(s)*
- Additional Elementary Spell Bowl Team(s) Quantity
  
  Price:
  $50.00
- Elementary Spell Bowl Coach #1
  
  First
  
  Last
- Elementary Spell Bowl Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Elementary Spell Bowl Coach?
- Elementary Spell Bowl Coach #2
  
  First
  
  Last
- Elementary Spell Bowl Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Elementary Spell Bowl Coach?
- Elementary Spell Bowl Coach #3
  
  First
  
  Last
- Elementary Spell Bowl Coach #3 Email
  
  Enter Email
  
  Confirm Email
- Register for Elementary Science Bowl*
- Elementary Science Bowl
  
  Price:
- Add Additional Elementary Science Bowl Team(s)*
- Additional Elementary Science Bowl Team(s) Quantity
  
  Price:
  $50.00
- Elementary Science Bowl Coach #1
  
  First
  
  Last
- Elementary Science Bowl Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Elementary Science Bowl Coach?
- Elementary Science Bowl Coach #2
  
  First
  
  Last
- Elementary Science Bowl Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Elementary Science Bowl Coach?
- Elementary Science Bowl Coach #3
  
  First
  
  Last
- Elementary Science Bowl Coach #3 Email
  
  Enter Email
  
  Confirm Email
- Register for Elementary M.A.T.H. Bowl*
- Elementary M.A.T.H. Bowl
  
  Price:
- Add Additional Elementary M.A.T.H. Bowl Team(s)*
- Additional Elementary M.A.T.H. Bowl Team(s) Quantity
  
  Price:
  $50.00
- Elementary M.A.T.H. Bowl Coach #1
  
  First
  
  Last
- Elementary M.A.T.H. Bowl Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Elementary M.A.T.H. Bowl Coach?
- Elementary M.A.T.H. Bowl Coach #2
  
  First
  
  Last
- Elementary M.A.T.H. Bowl Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Elementary M.A.T.H. Bowl Coach?
- Elementary M.A.T.H. Bowl Coach #3
  
  First
  
  Last
- Elementary M.A.T.H. Bowl Coach #3 Email
  
  Enter Email
  
  Confirm Email
- JUNIOR
- Register for Junior Contests by making a selection in each box below.
- Register for Junior eSports*
- Register for Junior eSports (Fall Season Only)*
- Junior eSports (Fall Season Only)
  
  Price:
- Register for Junior eSports (Spring Season Only)*
- Junior eSports (Spring Season Only)
  
  Price:
- Junior eSports Coach #1
  
  First
  
  Last
- Junior eSports Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Junior eSports Coach?
- Junior eSports Coach #2
  
  First
  
  Last
- Junior eSports Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Junior eSports Coach?
- Junior eSports Coach #3
  
  First
  
  Last
- Junior eSports Coach #3 Email
  
  Enter Email
  
  Confirm Email
- Register for Junior Spell Bowl*
- Junior Spell Bowl
  
  Price:
- Add an Additional Junior Spell Bowl Team*
- Additional Junior Spell Bowl Team
  
  Price:
- Junior Spell Bowl Coach #1
  
  First
  
  Last
- Junior Spell Bowl Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Junior Spell Bowl Coach?
- Junior Spell Bowl Coach #2
  
  First
  
  Last
- Junior Spell Bowl Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Junior Spell Bowl Coach?
- Junior Spell Bowl Coach #3
  
  First
  
  Last
- Junior Spell Bowl Coach #3 Email
  
  Enter Email
  
  Confirm Email
- Register for Junior Academic Quiz Bowl*
- Junior Academic Quiz Bowl
  
  Price:
- Add an Additional Junior Academic Quiz Bowl Team*
- Additional Junior Academic Quiz Bowl Team
  
  Price:
- Junior Academic Quiz Bowl Coach #1
  
  First
  
  Last
- Junior Academic Quiz Bowl Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Junior Academic Quiz Bowl Coach?
- Junior Academic Quiz Bowl Coach #2
  
  First
  
  Last
- Junior Academic Quiz Bowl Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Junior Academic Quiz Bowl Coach?
- Junior Academic Quiz Bowl Coach #3
  
  First
  
  Last
- Junior Academic Quiz Bowl Coach #3 Email
  
  Enter Email
  
  Confirm Email
- Register for Junior Academic Super Bowl*
- Junior Academic Super Bowl
  
  Price:
- Add an Additional Junior Academic Super Bowl Team*
  Adding an additional team allows a school to field 1 additional squad in any or all subject rounds based on student interest.
- Additional Junior Academic Super Bowl Team
  
  Price:
- Junior Academic Super Bowl Coach #1
  
  First
  
  Last
- Junior Academic Super Bowl Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Junior Academic Super Bowl Coach?
- Junior Academic Super Bowl Coach #2
  
  First
  
  Last
- Junior Academic Super Bowl Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Junior Academic Super Bowl Coach?
- Junior Academic Super Bowl Coach #3
  
  First
  
  Last
- Junior Academic Super Bowl Coach #3 Email
  
  Enter Email
  
  Confirm Email
- SENIOR
- Register for Senior Contests by making a selection in each box below.
- Register for Senior eSports*
- Register for Senior eSports (Fall Season Only)*
- Senior eSports (Fall Season Only)
  
  Price:
- Register for Senior eSports (Spring Season Only)*
- Senior eSports (Spring Season Only)
  
  Price:
- Senior eSports Coach #1
  
  First
  
  Last
- Senior eSports Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Senior eSports Coach?
- Senior eSports Coach #2
  
  First
  
  Last
- Senior eSports Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Senior eSports Coach?
- Senior eSports Coach #3
  
  First
  
  Last
- Senior eSports Coach #3 Email
  
  Enter Email
  
  Confirm Email
- Register for Senior Spell Bowl*
- Senior Spell Bowl
  
  Price:
- Add an Additional Senior Spell Bowl Team*
- Additional Senior Spell Bowl Team
  
  Price:
- Senior Spell Bowl Coach #1
  
  First
  
  Last
- Senior Spell Bowl Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Senior Spell Bowl Coach?
- Senior Spell Bowl Coach #2
  
  First
  
  Last
- Senior Spell Bowl Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Senior Spell Bowl Coach?
- Senior Spell Bowl Coach #3
  
  First
  
  Last
- Senior Spell Bowl Coach #3 Email
  
  Enter Email
  
  Confirm Email
- Register for Senior Academic Quiz Bowl*
- Senior Academic Quiz Bowl
  
  Price:
- Add an Additional Senior Academic Quiz Bowl Team*
- Additional Senior Academic Quiz Bowl Team
  
  Price:
- Senior Academic Quiz Bowl Coach #1
  
  First
  
  Last
- Senior Academic Quiz Bowl Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Senior Academic Quiz Bowl Coach?
- Senior Academic Quiz Bowl Coach #2
  
  First
  
  Last
- Senior Academic Quiz Bowl Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Senior Academic Quiz Bowl Coach?
- Senior Academic Quiz Bowl Coach #3
  
  First
  
  Last
- Senior Academic Quiz Bowl Coach #3 Email
  
  Enter Email
  
  Confirm Email
- Register for Senior Academic Super Bowl*
- Senior Academic Super Bowl
  
  Price:
- Add an Additional Senior Academic Super Bowl Team*
  
  Adding an additional team allows a school to field 1 additional squad in any or all subject rounds based on student interest.
- Additional Senior Academic Super Bowl Team
  
  Price:
- Senior Academic Super Bowl Coach #1
  
  First
  
  Last
- Senior Academic Super Bowl Coach #1 Email
  
  Enter Email
  
  Confirm Email
- Add Another Senior Academic Super Bowl Coach?
- Senior Academic Super Bowl Coach #2
  
  First
  
  Last
- Senior Academic Super Bowl Coach #2 Email
  
  Enter Email
  
  Confirm Email
- Add Another Senior Academic Super Bowl Coach?
- Senior Academic Super Bowl Coach #3
  
  First
  
  Last
- Senior Academic Super Bowl Coach #3 Email
  
  Enter Email
  
  Confirm Email
- Payment Instructions
  
  Payment may be completed now via Credit Card via PayPal. If you wish to pay by check, an invoice will be emailed to the contact listed in the Treasurer field on this form typically within a week after your membership form is received and processed.
- Total
  $0.00
- Payment will be made by:*

70249

Department of Student Programs Membership Fee

Academic Competitions

ELEMENTARY

JUNIOR

SENIOR

Payment Instructions