Caucuses are required to have at least 25 members and are now required to submit a list of its members and their signatures to the NEA. Please print, complete, and submit the following form.
NEA Ex-Gay Educators’ Caucus Membership
I currently am an NEA member and would like to join the NEA Ex-Gay Educators’ Caucus for 2018-19.
Printed Name Signature
(The following portion of the form to be retained solely by the caucus for conducting caucus business.)
Name: Last_________________________________ First________________________
Postal Address _____________________________________________
City ____________________________ State ____________ Zip _______
Phone contact with area code______________________
Issues of interest:
Is there a particular type of volunteer work you are interested in: (Check all that apply.)
____Public speaking/training ____ Writing letters ____ Fundraising
____ Research ____CPA, accounting, budget ____Lobbying
____ Distribute caucus brochures, etc. to inform NEA members of the caucus and its goals.
____ Host a caucus exhibit booth in your area
____ Grant writing ____ Answering emails ____ Website management
Other (Specify): ________________________________________
Donations for caucus expenses (optional):
$ _______ Total amount enclosed
Make checks payable to Ex-Gay Educators’ Caucus (not tax deductible)
Please mail form and payment to:
NEA Ex-Gay Educators’ Caucus
P.O. Box 543
Cottage Grove, MN 55016
If using PayPal: http://www.PayPal.Me/exgay
Please submit questions to firstname.lastname@example.org
The views expressed in this document are those of the caucus. The caucus has no authority to speak for, or act on behalf of, the NEA.