1. Perpetuate the ideals of Horace Mann.
2. Preserve and support quality public schools.
3. Preserve the separation of church and state.
Address ________________________________________________________
City ______________________ State _____ Zip _______________________
Work Phone ( ) _____ _________ FAX ( ) _____ _____________
Internet e-mail ______________________ @ ___________________________
Position _________________________________________________________
Your highest degree was earned at (Name of university)____________________
Nominated by (optional) _____________________________________
Annual Dues: $65.00 (Federal ID: 52-6054490)
Make check to:
The Horace Mann League of the USA
560 Rainier Lane
Port Ludlow, WA 98365
Account No. __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ __ Exp. Date ____
Signature required ___________________Phone (_ _ _) __ __ __-__ __ __ __
Email:
jmckay@hmleague.org
FAX (866) 389 0740
Phone (360) 437 1186