ILACEP Membership Application

If you are paying your membership fee by check, please make them payable to ILACEP and mail with a copy of your confirmation:

Illinois Alliance of Concurrent Enrollment Partnerships
c/o Rachel Sveda-Webb, Treasurer
John A. Logan College
700 Logan College Drive
Carterville, IL 62918

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Institution Name
Institutional Type
Address Address
Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country
Member1-Primary Contact/Designated Voting Member (Institutional memberships only) Member1-Primary Contact/Designated Voting Member (Institutional memberships only) First Last
Title/Position
Email
Phone Phone - ### - ### ####
Member 2/Alternate Voting Member (Institutional memberships only) Member 2/Alternate Voting Member (Institutional memberships only) First Last
Title/Position
Email
Phone Phone - ### - ### ####
Please list any additional colleagues that you would like to be added to your membership.

Please include:
- Full Name
- Title
- Phone Number
- Email Address
$0

Total

ILACEP Membership Application

ILACEP Membership Application

$0

Total

$`0`