MASA

Michigan Association
of School Administrators

1001 Centennial Way
Suite 300
Lansing, MI 48917-9279
(517) 327-5910
F: (517) 327-0771

SAPAC Member Enrollment

School Administrators
Political Action Committee

First Name:
Last Name:
Employer:	(required)
Occupation:	(required)
Phone Number:
Amount:	$ ($100 = "SAPAC Sticker" membership)

You must check each of the boxes below to meet federal contribution requirements:

This contribution is made from my own funds, and not from those of another.

This contribution is not made from general treasury fund of a corporation, labor organization or national bank.

I am not a Federal Government Contractor, nor am I a Foreign National who lacks permanent resident status in the United States.

This contribution is made on a personal credit card or debit card for which I have a legal obligation to pay, and is made neither on a corporate or business entity card nor on the card of another.

MASA Sponsors