* Required

Affiliate Status is open to any organization that supports NESA's mission and vision, shares NESA's core values, and wishes to participate in NESA's conferences and institutes and enjoy the privileges of Affiliate Status.

Name of Institutionrequired

Address Line 1required

Address Line 2

Cityrequired

State/Province

Postal Code

Countryrequired

Phone

Emailrequired

Website

Twitter

Facebook

Other Social Media

Profilerequired

A short paragraph describing your school or school system.

How did you hear about NESA?

Head of Institutionrequired

Job Titlerequired

Email Addressrequired

Contact Personrequired

Job Titlerequired

Email Addressrequired

Logo Upload

NESA will feature your organization's logo and link to your website on a public page on the NESA site.

Please upload your logo here, or send it by email to ranya@nesacenter.org.

LOGO SPECS
Transparent background PNG file. Minimum size: 200px at 72 dpi.

Attach Logo

Max file size: 10 MB

Annual Affiliate dues are $1,800 (reduced by 20% from $2,250 for the 2021-2022 year); the year runs from July 1 to June 30.

Electronic Signature of Head of Institution (or representative)

Daterequired (mm/dd/yyyy)

Please send a confirmation email to the address below*: