Change of Status Form 

If you will be changing positions for the 2018-19 school year, retiring, or leaving the field entirely,
please let us know. This helps to ensure continuous membership for the new school year. Current
memberships expire August 31, 2018.

Please fill in fields where information is changing for 2018-19. No changes to a field? It's okay to leave it blank. 

For more information
Annalee Braley | Membership Services Support | 800.562.6100

*Name:  
*Title for 2018-19:  
*Name of School:  
*Name of District:  
*School/Work Email:    
*Personal Email:    
*Preferred Email Address:  
School/Work Phone:
School/Work Fax:
Home Phone:
Cell Phone:
Home Address:
City:
State:
Zip:
Send my snail mail to:
I am working under the
Retire/Rehire program:
Please change my AWSP membership status for the following reason:



Additional Information: