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1. Last Name*

2. First Name*

3. Street Address*

4. City*

5. State*

6. Country*

7. Postal Code*

8. E-mail*

9. Date Submitted*

10. Select type of Membership:*

11. Method for receiving publications:*

12. Donation to IASE Project? (Optional)12.

13. If yes above, please select a project

14. If yes above, amount of donation: (you will be contacted by our IASE treasurer with your tax receipt)

15. TOTAL PAYMENT: (Add Membership fee, sponsorships and donation - if applicable)*

Thank you for your Membership Application. Please hit the Back button to return to our website's Membership page and complete membership payment by hitting the PAY NOW button. You will be contacted within the week about your membership. Welcome to IASE!

International Association of Special Education

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