AND
Please complete and return to:
Lorell Jungling
(DO NOT MAIL IN YOUR DUES TO NIAAA)
First Name______________________M.I. ____Last Name________________________Suffix:____ (Jr., III, etc)
(As it appears on your driver’s license)
School or Organization: _______________________________ Title: __________________No. Years AD ____________
Office Address:_____________________________________________________________District:_____ Class:_______
City:
Office Phone: (______)_________ Home Phone: (_____)__________ Preferred Mailing Address: Home ___School ____
Fax: (______)______________________ E-Mail Address:________________________________________________
For NIAAA insurance purposes, the following information must be provided:
SSN: _______________ Birth date: ____-_____-______ Male ___ Female ___ Smoker – Yes _____ No ______
Home Address:__________________________________________________________________________________
City:
The NIAAA studies diversity among our membership. In this regard, a database has been instituted to collect this information from our membership. We appreciate your completion of this section so we may better serve our membership>
________ Caucasian ________ Latino ________ American Indian ________ Asian
________ Pacific Islander ________ African American ________ Multi-Cultural ________ Alaskan Native
If none of the above codes seem appropriate, please indicate your background: ______________________________________________________
(Check payable to: NDIAAA) (Date Rcvd. _____________
NDIAAA/NIAAA MEMBERSHIP INFORMATION
If you are involved in administrating interscholastic athletics at the high school, middle school or junior high level then you should join these professional organizations.
The NIAAA is a national professional organization and the NDIAAA is the state professional organization administered by, and for, athletic administrators for the purpose of:
· Promoting professional growth and image of interscholastic athletic administrators
· Promoting the development and prestige of state athletic administrators organizations, which will contribute, in cooperation with state high school associations, to the interscholastic athletic program of each state
· Providing an efficient system for exchange of ideas between the NFHS and state athletic directors organizations and individual athletic administrators
· Preserving an educational nature of interscholastic athletics and the place of these programs in the curricula of schools
MEMBERSHIP BENEFITS
· The IAA, a quarterly professional journal written by and for athletic administrators
· The NDIAAA website access
· $1,000,000 liability insurance while performing the duties of an athletic administrator (an additional $1,000,000 for those who have taken LTP 501 and LTP 504)
· $2500 term life insurance
·
· Discount on registration fees for the NFHS National Conference for high school directors of athletics
· Opportunities to serve on national committees and state committees and board of directors.
· Opportunity to submit student scholarship applications for students from your school.
· Opportunity to purchase long-term health care at significantly discounted prices.
· Registration Fee of only $1.00 for “From the Gym to the Jury” online newsletter. Reg. $39.95 for non-member.
