Chinese School Association in the United States Membership Registration:

School Name in Chinese

* School Name in English

Region

Permanent Mailing Address of the School (If there isnt one, enter Principals address)

Street Address or P. O. Box #

City

State

Zip

School Building (Check one item) 1=Owned 2=Rented 3=Borrowed (free)

Building Owner

Building Name & Street Address

City of the Building

State

Zip

Web URL of the School

School Email Address

Name of the Text Book Series

Number of Students

Number of Students from None Chinese Spoken Families

Number of Teachers

School Established Since

[] New member, to joint

[ ] Old member, to re-joint

[ ] Current member, to renew

Continue Membership Date

The first Membership Date

The Annual Membership Fee ($75) Payment Records

2018 Pay Date

2017 Pay Date

2016 Pay Date

2015 Pay Date

2014 Pay Date

2013 Pay Date

2012 Pay Date

2011 Pay Date

[ ] Independent school (ID=0)*

[ ] General school with (-ID) branches

[] Branch school (ID>0)

ID of
General School

Chinese Name of General School

English Name of
General School

Region of
general School

Principal's Chinese Name

Principal's Last Name

Principal's First Name

Principal's Title

Principal's Email

Mr.
Ms.

Street Address of Principal

City of Principal

State

Zip

Principal's major Ph. (123-456-7890)

Other Phone Numbers: Office(O), Cell(C), Pager(P)

Fax Numbers

* Your Email For Confirmation

Note:

1. With on-line-join, your data will be sent to CSAUS data-manager immediately. But you still need to mail in the membership fee. Upon the

arrival of your payment, all data will be recorded to complete the registration process.

2. The membership fee is $75 per year. You may elect to pay any amount in the increment of $75 to prepay for the following years.

Please indicate: [ ] Enclosed is the total payment of $________ to pay the membership fee of year __________, year ___________,
year ___________, and years _____________________. The check number is _____________

3. Upon completion of the form, PRINT THIS FORM (see button below), with a payment check, payable to CSAUS, and mail to

    Attn. Ms. Tang

  CSAUS Memeber Services,

  5925 Sovereign Dr. Suite 115, Houston, TX 77036, USA

4. Upon the completion of the registration, we will send you a receipt for fee paid, a notifying email as your email added to CSAUS

distribution list, and quarterly newsletter since then. And you can verify your membership at our website "School Search".

5. For inquiries, please send email to office@csaus.net; and for other information about CSAUS: http://csaus.net

* The general school and its branch schools should fill separate forms. The general school should indicate how many branches it has and the branch school should indicate which general school it belongs to. Only the general school has membership and needs to pay membership fees.