OSCA Membership Application

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Last Name First MI

Home Address

City State Zip

School Name Grades to

School Address

City State Zip

Home Phone Work Phone Email

Preferred Mailing Address: Home Work Email

I desire the type of membership indicated below :

ORCA/OSCA Dual Professional . . . . . . . . . . . $77.50

OSCA Professional Associate . . . . . . . . . . . $35.00

Student Membership. . . . . . . . . . . . . . $10.00

Student membership is available to full-time students with verification by major professor.

Professor's Name & Institution

New Graduate Membership (photocopy of diploma will be requested) .

Retired Membership. . . . . . . . . . . . . . $10.00

I desire a return-receipt via email that this application was received

A check for the correct amount made out to Oregon School Counseling Association (OSCA) must be received within 10 days at: OSCA, PO Box 5501, Salem, OR 97304-0501.

Statement of Ethical Standards: I have read and agree to subscribe to the Ethical Standards of the Oregon Counseling Association. If agreed, click the "submit" button below. If not, click the "reset" button


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