NMADA Membership Form | NMACT Online Forms

Name*

First Middle Initial Last

Email*

Cell Phone*

School*

School Address*

Street Address City State ZIP Code

School Phone*

School Fax*

Principal's Name*

First Last

Suptintendent's Name*

First Last

Please indicate your general areas/levels of athletic director/coordinator duties:*

Please indicate current additional roles/duties beyond AD/AC (if any) with your school/district:

Teacher
Coach
Asst Principal
Other

Please explain other:*

Please indicate source of dues payment/funding:*

School/District
Personal

Do you currently hold a NM Administrative License:*

Yes
No

Are you a current member of NIAAA (Nat’l Interscholastic AD Ass’n)*

Yes
No

Number of years of previous experience as an Athletic Director/Coordinator:*

MEMBERSHIP FEES

High School or High School and MS/JH - $50.00
Lifetime-Retired - $50.00
MS/JH or Assistant AD/AC* or Retired or Others - $25.00

*Note – Assistant AD/AC open to assistants and administrative assistants when combined with a full $50.00 membership from the same school/district

PAYMENT

PLEASE MAKE P.O.’s AND CHECKS PAYABLE TO NMAA-NMADA AND SEND TO:

Tammy Richards
NMAA-NMADA
6600 Palomas NE
Albuquerque, NM 87109

E-mail: tammy@nmact.org
Phone: 505.923.3278
Fax: 505.923.3114

Membership Form- 2020-21 School Year

MEMBERSHIP FEES

PAYMENT