Association of Christian Teachers and Schools
911 S. Parsons Ave Ste G, Brandon, FL 33511 P: 813-684-2024 F: 813-684-2026
ANNUAL MEMBERSHIP APPLICATION
Annual membership is valid from July 1st through June 30th
Date:
School Name:
Mailing Address:
City:
State:
Phone Number:
ZIP Code:
Fax Number:
Email Address: (Required)
School Website:
Are you a Church sponsored school?
Are you an independent Christian school?
STUDENT ENROLLMENT
Please Enter Number of Students per Grade
PS
7th
1st
8th
2nd
9th
3rd
10th
4th
11th
5th
12th
Domestic Dues Scale
1-25 Students ---- $125.00
26-749 Students ---- $5.00 Per Student
750+ Students ---- $3750.00
Total Students: __________
Amount Due $___________
Payment after Sept 15th is subject to a $75.00 late fee
for current Member Schools.
International Rate
$125.00
6th
Check one:
Check Enclosed _____ Paid Online _____
SIGNATURES
Administrator’s Name:
By entering your name you acknowledge reading and understanding the above document, and I hereby certify that the information above is true and
accurate.
Administrator’s Signature:
Please mail the completed application along with payment to:
ACTS
911 S. Parsons Ave Ste G
Brandon, FL 33511