Application for Ohio Scholarship to attend the 2023 NEA National Leadership Summit Name(Required) First Last Local Association(Required)ACCESSADA CLASSIFIED ASSOCIATIONADA E. A.ADENA E. A.AKRON CLASSIFIEDALEXANDER LOCAL E.A.ALLEN EAST E. A.ALLIANCE E. A.AMANDA-CLEARCREEK E.A.AMANDA-CLEARCREEK S.S.A.AMHERST T.A.ANNA LOCAL T.A.ANSONIA E.A.ANSONIA LOCAL SUP PERSANTHONY WAYNE E. A.ANTWERP E. A.APOLLO E.A.ARCANUM BUTLER C.T.A.ARCHBOLD E. A.ASHCO D.D. E.A.ASHLAND CITY T. A.ASHLAND VOCATIONAL T.A.ASHTABULA A.C.S.E.ASHTABULA AREA T.A.ASHTABULA CO. EMP. ASSN.ASHTABULA JVSD T AATCO - BEACON E. A.ATHENS E. A.AURORA E. A.AUSTINTOWN E. A.AVON LAKE E. A.AVON T. A.AYERSVILLE E.A.BADGER E. A.BARBERTON E. A.BARNESVILLE A CLASS EMPBARNESVILLE E.A.BATAVIA PROF. E.A.BATH E. A.BAY INDIV-SM GROUP INST TABAY T.A.BEAVERCREEK CLASSIFIED EMPBEAVERCREEK E.A.BEAVER LOC. E.A.BEDFORD E.A.BELLAIRE E.A.BELLEFONTAINE E. A.BELLEVUE E. A.BELMONT-HARRISON VOC. E.A.BELPRE E.A.BENJAMIN LOGAN E. ABERKSHIRE E. A.BERNE UNION E.A.BETHEL E.A.BETHEL-TATE T.A.BEXLEY E.A.BIG WALNUT E. A.BIG WALNUT PROF S.S.BLACK RIVER S.S.P.BLACK RIVER T. A.BLANCHESTER E ABLOOM CARROLL E.A.BLOOMFIELD-MESPO E. A.BLUFFTON E. A.BOARDMAN E. A.BOWLING GREEN E. A.BRADFORD T. A.BRECKSVILLE BRDVIEW HTS E ABRECKSVILLE BRDVIEW HTS S SBRIDGEPORT A. OF CLSS.BRIDGEPORT E. A.BRIGHT T.E.A.BRISTOL A. OF SCHL EMP.BROOKFIELD ASSN OF SCHL EMPBROOKLYN E. A.BROOKVILLE T. A.BRUNSWICK E. A.BRUNSWICK E.S.P.BRYAN E. A.BUCKEYE CENTRAL E. A.BUCKEYE E. A. ASHTABULABUCKEYE E.A. J.V.S.BUCKEYE HILLS S.S.BUCKEYE HILLS T.A.BUCKEYE LOC C.T.A.BUCKEYE VALLEY T. A.BUCYRUS E. A.BUCYRUS ORG OF S.S.BUTLER EDUCATION ASSNCALDWELL T. A.CAMBRIDGE T.A.CAMPBELL E. A.CANAL WINCHESTER E. A.CANFIELD BUS DRIVERS ASSNCANFIELD E. A.CANTON LOCAL CLSFD ASSNCANTON LOCAL E. A.CANTON PROF E. A.CARDINAL E. A.CARDINGTON-LINCOLN FAC.CAREER AND TECHNICAL ASSNCAREY E. A.CARLETON SHL MEIGS INDCARLISLE T. A.CARROLLTON E. A.CEDAR CLIFF E. A.CELINA E. A.CENTERBURG T.A.CENTERVILLE C.T.A.CHAGRIN FALLS E.A.CHAMPION E.A.CHAMPION LOCAL S.S.P.CHARDON ACECHARDON E. A.C H A S ECHESAPEAKE LOCAL T.A.CHILLICOTHE E. A.CHIPPEWA E.A.CIRCLEVILLE E. A.CLARK CO VOC ASSN OF SECLARK CO VOCATIONAL E.A.CLARK-SHAWNEE LOCAL E.A.CLAY E.A.CLAYMONT E.A.CLEARVIEW E. A.CLERMONT COUNTY SPECIAL E ACLERMONT NE E. A.CLINTON MASSIE E.ACLOVERLEAF E. A.CLYDE GREEN SPRINGS E.A.COL CRAWFORD E. A.COLDWATER T.O.COLUMBIA LOC E. A.COLUMBIANA ASSOCIATED EMPLCOLUMBIANA E.A.COLUMBIANA LOCAL ASSN OF SSCOLUMBUS E. A.COLUMBUS GROVE E. A.COLUMBUS STATE E. A.CONNEAUT CLASS EMPL.CONNEAUT E. A.CONOTTON VALLEY T.A.CONTINENTAL E. A.COPLEY T.A.COSHOCTON CITY E. A.COSHOCTON COUNTY C.C. E.A.COVENTRY E ACOVINGTON E.A.CRESTLINE E.A.CRESTVIEW E.A.- COLUMBIANACRESTVIEW T. A.- RICHLANDCRESTWOOD E.A.C-T E C T.E.A.CUYAHOGA FALLS E. A.CUYAHOGA HTS A OF TDALTON LOCAL E. A.DANBURY ASSN NON-TEACHINGDANBURY E.A.DAWSON BRYANT E. A.DAYTON E ADEER PARK E. A.DEFIANCE CITY E. A.DELAWARE AREA CAREER CTR E.A.DELAWARE CITY T. A.DELPHOS E. A.DOVER E.A.DUBLIN E.A.DUBLIN SUPPORT ASSOCIATIONEAST CANTON E.A.EAST CLEVELAND E. A.EAST CLINTON E. A.EASTERN GATEWAY COM COL E AEASTERN LOCAL C.T.A.- PIKEEASTERN LOCAL E.A.- BROWNEASTERN LOCAL E.A.- MEIGSEASTERN LOCAL S.S.P. ASSNEAST GUERNSEY LOCAL S.A.EAST GUERNSEY LOCAL T.A.EAST HOLMES T. A.EAST KNOX E. A.EASTLAND E. A.EAST LIVERPOOL E.A.EAST PALESTINE E. A.EASTWOOD E. A.EATON C.T.A.EATON S.S.P.ED. ASSN OF ORRVILLEED. ASSN OF PIONEERED. OF MONTGOMERY COUNTYEDGERTON E. A.EDGEWOOD T.A.EDISON LOC E. A.EDISON STATE E.A.EDISON T. A.EDON NORTHWEST T.A.EHOVE T. A.ELGIN E.A.ELIDA E.A.ELMWOOD E. A.ELYRIA E. A.EUCLID CLASSIFIED ASSNEUCLID CLSFD - TRANSPORTATIONEUCLID T. A.EVERGREEN E. A.FAIRBANKS E. A.FAIRBORN E. A.FAIRFIELD C.T.A. BUTLERFAIRFIELD E.A. HIGHLANDFAIRFIELD UNION E.A.FAIRLAND A.C.T.FAIRLESS E. A.FAIRPORT HARBOR T.A.FAIRVIEW PARK E.A.FAYETTEVILLE-PERRY CLSFD EAFAYETTEVILLE-PERRY E.A.FEDERAL HOCKING T.A.FELICITY E.A.FIELD LOCAL T.A.FINDLAY E. A.FINNEYTOWN A.S.P.FINNEYTOWN E.A.FIRELANDS E.A.FOREST HILLS T.A.FOREST ROSE E.A.FORT FRYE T. A.FORT JENNINGS E. A.FORT LORAMIE E.A.FORT RECOVERY E. A.FOSTORIA E. A.FOUR COUNTY J.V. E.A.FRANKLIN COUNTY BD OF DD EAFRANKLIN E. A.- WARRENFRANKLIN LOCAL T.A.FRANKLIN MONROE E. A.FREDERICKTOWN E. A.FREMONT E. A.FRONTIER LOC. E.AGAHANNA-JEFFERSON E. A.GALION E.A.GALLIA CO. LOCAL E.A.GALLIA CO. LOCAL S.S.GALLIPOLIS E. A.GARAWAY T.A.GARFIELD E. A.GARFIELD HTS T. A.GEAUGA SCHOOL EMPL ASSNGENEVA AREA T AGIBSONBURG T. A.GIRARD E. A.GOOD SAMARITAN E.A.GORHAM FAYETTE T.A.GOSHEN E.A.GOSHEN E.A.- S.S.A.GRAHAM E. A.GRAND VALLEY S.S.P.GRANDVIEW HTS E.A.GRANDVIEW HTS EDUC. S.S.A.GRANVILLE E. A.GREEN E. A.- SUMMITGREENE COUNTY C.C. E AGREENE COUNTY C C CLSFD E AGREENEVIEW CLASSIFIED E.A.GREENEVIEW E. A.GREENFIELD EX VLG E.A.GREEN LOCAL ASSN OF S.S.GREEN LOCAL E.A.- WAYNEGREEN LOCAL T.A.- SCIOTOGREENVILLE E. A.GROVEPORT-MADISON E.A.GUERNSEY NOBLE E.A.HAMILTON C.T.A.- BUTLERHAMILTON CO. E.A.HAMILTON LOCAL E.A.HARDIN HOUSTON E. A.HARDIN NORTHERN E. A.HARRISON HILLS T.A.HEATH E. A.HEATH ED'L S.S.A.HICKSVILLE E. A.HIGHLAND E. A.- MEDINAHIGHLAND E. A.- MORROWHIGHLAND SUPPORT STAFFHILLIARD E.A.HILLSBORO E.A.HILLSDALE E.A.HOCKING TECH COLLHOCKING TECH SSPHOLGATE T.A.HOPEWELL E. A.HOPEWELL LOUDON E.A.HOWLAND C.T.A.HUBBARD E.A.HUBER HEIGHTS E.A.HUDSON E. A.HUNTINGTON LOCAL E.A.HURON CLASSIFIED E.A.HURON E.A.INDEPENDENCE CLS EMP ASSNINDEPENDENCE E. A.INDIAN CREEK E. A.INDIAN LAKE A C EINDIAN LAKE E. A.INDIAN VALLEY T.A.IRONTON E. A.IRONTON S.S.A.JACKSON CITY E. A.JACKSON CLASSIFIED PERS ASSNJACKSON MEMORIAL E. A.JEFFERSON AREA T.A.JEFFERSON CO J.V.S. T.A.JEFFERSON TOWNSHIP E.A.JOHNSTOWN E. A.JONATHAN ALDER E. A.KALIDA E.A.KENSTON E. A.KENTON E. A.KETTERING E.A.KEYSTONE LOC E AKINGS E.A.KIRTLAND E. A.KNOX COUNTY CAREER CENTERKNOX NEW HOPE CTR. E.A.LABRAE T. A.LAKE E. A.- WOODLAKELAND FACULTY ASSNLAKE LOC E. A.- STARKLAKEVIEW SCHOOL SUPT ASSNLAKEVIEW T. A.LAKEWOOD CLASSIFIEDLAKEWOOD T.A.- CUYAHOGALAKEWOOD T.A.- LICKINGLAKOTA E.A.- BUTLERLAKOTA E.A.- SANDUSKYLAKOTA S.S.A.- BUTLERLANCASTER E.A.LANCASTER S.S.A.LAWRENCE CO. VOC T.A.L E A D DLEBANON E.A.LEETONIA E. A.LEIPSIC E.A.LEXINGTON S.S.A.LEXINGTON T. A.LIBERTY ASSN OF SCH EMPLLIBERTY CENTER C.T.A.LIBERTY UNION THURSTON E.A.LICKING HEIGHTS E. A.LICKING HEIGHTS ESP ASSNLICKING VALLEY E.A.LIMA E.A.LINCOLNVIEW LOCAL E.A.LISBON E.A.LITTLE MIAMI T.A.LOCKLAND E. A.LOGAN E. A.LOGAN ELM C.T.A.LONDON E. A.LORAIN ASSN CLASSIFIED EMPLORAIN COUNTY JVS T.A.LORAIN E. A.LOUDONVILLE PERRYSVLE E.A.LOUISVILLE E. A.LOVELAND E. A.LOWELLVILLE E.A.LUCAS T. A.MADISON E. A.- BUTLERMADISON E.A.- LAKEMADISON LOC E A- RICHLANDMADISON PLAINS E. A.MAD RIVER E.A.MAHONING CO. CTC CLSFDMAHONING CO CAREER AND TECH CTRMALVERN E.A.MANCHESTER E.A.MANCHESTER OHIO RIVERMANSFIELD SCHL EMPL ANMAPLE HTS. T.A.MAPLE ORGANIZ. SUPPORT TEAMMAPLETON T. A.MAPLEWOOD CAREER CTR E.A.MAPLEWOOD E.A.MARGARETTA T. A.MARIETTA E.A.MARIMOR E.A.MARION E. A. - MARIONMARION LOC E. A. - MERCERMARLINGTON E. A.MARTINS FERRY E.A.MARYSVILLE E. A.MASON E. A.MASSILLON E. A.MATHEWS E.A.MAUMEE E. A.MAYFIELD A. OF S.P.MAYFIELD E.A.MAYSVILLE CLASSIFIED EAMAYSVILLE E. A.MCCOMB T.E.A.MCDONALD E. A.M E A D DMECHANICSBURG E. A.MEDINA CITY SCHLS PSYCHOLOGISTSMEDINA CITY T. A.MEDINA CO ACHVMT CENTER E AMEDINA CO VOC. CTRMEIGS LOCAL T. A.MENTOR CLASSIFIED EMPLOYEESMENTOR T. A.METZENBAUM E. A.MIAMI EAST A.S.P.MIAMI EAST E. A.MIAMISBURG C.T.A.MIAMI TRACE E.A.MIAMI TRACE NON-CERT E.A.MIDDLETOWN CLASSI E.A.MIDDLETOWN T.A.MIDD-ROE EMPLOYEES UNIONMID EAST E.A.MILFORD CLASS. EMP. A.MILFORD E. A.MILLCREEK W UNITY E. A.MILLER-CTY-NEW CLEVELAND EAMILTON UNION E. A.MINERVA LOCAL E.A.MINFORD E. A.MINSTER T. A.MISSISSINAWA VAL T. A.MOGADORE E.A.MOGADORE E.S.A.MOHAWK E. A.MONROE COUNTY E.A.MONROE EDUCATION ASSNMONROEVILLE T. A.MONTPELIER E.A.MORGAN LOC. E.A.MT GILEAD T. A.MT HEALTHY CLSFD EAMT HEALTHY T. A.MT VERNON E. A.NAPOLEON FACULTY A.NATIONAL TRAIL E. A.NELSONVILLE YORK E. A.NEWARK T. A.NEW BREMEN T. A.NEWBURY E.A.NEWCOMERSTOWN CLASSIFIEDNEWCOMERSTOWN T.A.NEW LONDON E.A.NEW MIAMI E.A.NEW PHILADELPHIA E.A.NEW RIEGEL E. A.NEWTON FALLS A.C.E.NEWTON T.A.NILES E.A.NOBLE LOCAL C.T.A.NOBLE LOCAL SUPPORT ASSNNORDONIA HILLS E. A.NORTH BALTIMORE E. A.NORTH CANTON CLASS. EMP.NORTH CANTON E. A.NORTH CENTRAL E A - WILLAMSNORTH COLLEGE HILL E.A.NORTHEASTERN LOCAL E.A.NORTHEASTERN LOCAL T.A.NORTHEASTERN LOC A OF S.E.NORTHERN LOCAL E.A.NORTH FORK E. A.NORTHMONT DIST E.A.NORTH OLMSTED E. A.NORTHRIDGE E. A.- LICKINGNORTHRIDGE T A-MONTGOMERYNORTH ROYALTON E. A.NORTH UNION E.A.NORTHWESTERN A OF SCH EMPLNORTHWESTERN LOC E.A.NORTHWESTERN T A - CLARKNORTHWEST LOCAL E.A.NORTHWEST ST COM COLNORTHWEST T. A. - STARKNORTHWOOD LOCAL E.A.NORTHWOOD LOCAL SCHOOLS S ANORTON C.T.A.NORWALK T. A.NORWAYNE E.A.NORWAYNE E.S.P. ASSNNORWOOD T. A.NW ASSOCIATION OF EDUCATORSOAK HARBOR E.A.OAK HILLS E.A.OAK HILL UNION LOCAL E.A.OAKWOOD T.A.OBERLIN OHIO E. A.OHIO VALLEY E.A.OLD FORT LOC E. A.OLENTANGY TEACHERS ASSNOLMSTED FALLS E.A.ORANGE TCHRS ASSNOTSEGO E. A.OTTAWA GLANDORF C.T.A.OTTAWA HILLS E. A.OTTAWA HILLS SUPPORT ASSNOTTOVILLE LOCAL E.A.PAINESVILLE CITY T. A.PAINT VALLEY LOC E.A.PANDORA GILBOA E. A.PARKWAY E. A.PARMA E. A.PATRICK HENRY E. A.PAULDING E. A.PENTA CAREER CENTER E. A.PERKINS E. A.PERRY ASSN OF SUPPORT STAFFPERRY C T A - LAKE COPERRY C T A - STARK COPERRY E. A. - ALLENPERRYSBURG E. A.PICKAWAY ROSS T.A.PICKERINGTON E.A.PICKERINGTON S.S.A.PIKE DELTA YORK E.A.PIKETON-SCIOTO E.A.PIQUA E. A.PLAIN LOC E. A. - FRANKLINPLAIN LOC T. A. - STARKPLEASANT A OF TPLYMOUTH E. A.POLAND E. A.POLARIS E. A.PORTAGE CO EDUCATORS FOR THE DDPORTAGE LAKES E. A.PORTSMOUTH CITY T. A.PREBLE-SHAWNEE LOCAL E.A.PRINCETON A. C. E.PUTNAM COUNTY E. A.PYMATUNING VALLEY E. A.RAVENNA E. A.READING E.A.REVERE E.A.REYNOLDSBURG E.A.REYNOLDSBURG S.S.A.RICHMOND HEIGHTS E.A.RIDGEDALE T. A.RIDGEMONT E.A.RIDGEWOOD E. A.RIPLEY-UNION-LEWIS E.A.RITTMAN E. A.RIVERDALE E. A.RIVERSIDE LOCAL E.A.RIVER VALLEY EMPLOYEES ASSNRIVER VALLEY T. A.RIVER VIEW E. A.ROBERT BYCROFT E.A.ROCK HILL E. A.ROCKY RIVER T. A.ROLLING HILLS E.A.ROOTSTOWN E. A.ROSS E.A.ROSSFORD A.C.T.RUSSIA E.A.S.C.O.P.E.SALEM E. A.SANDUSKY E.A.SANDY VALLEY E. A.SCIOTO CO CAREER TECH CTR T ASEBRING LOC E. A.SENECA EAST E. A.SHADYSIDE E. A.SHAWNEE CLASSIFIED EMP ASSNSHAWNEE E. A. - ALLENSHAWNEE E.A.- SCIOTO CO.SHEFFIELD-SHEFF LAKE T ASHEF-SHEFFIELD LAKE CLSFD E.A.SHELBY A. OF S.S.SHELBY E. A.SIDNEY E. A.SOUTH CENTRAL E. A.SOUTHEASTERN LOCAL E. A.SOUTHEASTERN LOCAL ESPSOUTHEASTERN LOCAL T ASOUTHEAST LOCAL DISTRICT TASOUTHEAST LOCAL E A - WAYNESOUTHEAST S.S.P. ASSNSOUTHERN HILLS J.V.S. T.A.SOUTHERN LOC E. A. - MEIGSSOUTHERN LOC E. A. - PERRYSOUTHERN LOC T.A. -COLUMBIANASOUTHERN STATE E.A.SOUTHINGTON E. A.SOUTH POINT A.C.T.SOUTH RANGE E. A.SOUTH-WESTERN E.A.SOUTHWEST LICKING E. A.SOUTHWEST LOC. C.T.A.SPENCERVILLE E. A.SPRINGBORO CLASS. EMPL.SPRINGBORO E. A.SPRINGFIELD E.A. - CLARKSPRINGFIELD E.A. - LUCASSPRINGFIELD E.S.P - SEUSSSPRINGFIELD LOCAL A.C.T.SPRINGFIELD LOCAL C.T.A.STARK AREA VOC. EDUCTRSSTARK CO EDUC PROF TRAINERSSTARK CO M.R.D.D. S.S.A.ST BERNARD-ELMWOOD PLC E AST CLAIRSVILLE E.A.STEUBENVILLE E. A.ST MARYS E.A.STOW MUNROE FALLS CLASS E ASTOW T. A.STREETSBORO E. A.STREETSBORO S.S.P.A.STRONGSVILLE E. A.STRUTHERS E. A.STRYKER E. A.SUGARCREEK E. A.SUGARCREEK LOCAL ASSN OF SPSWANTON E. A.SWANTON S.S. ASSNSWITZERLAND OF OHIO E. A.SYCAMORE E. A.SYLVANIA E.A.SYMMES VALLEY E. A.T. A. OF CENTRAL LOCT. A. OF LUCAS CO SCHOOLST. A. OF WASHINGTON LOCTALAWANDA CLASSIFIED S.A.TALAWANDA E. A.TALLMADGE TEACHERS ASSNTCHRS ORGN WEST RESVTEAYS VALLEY E. A.TECUMSEH E.A.THREE RIVERS A. OF S.S.P.THREE RIVERS E. A.TIFFIN E. A.TIPP CITY E.A.TOLLES E.A.TORONTO E. A.TRI-COUNTY NORTH E.A.TRI-COUNTY T. A.TRIMBLE LOC TEACHERS ASSNTRI-RIVERS E.A.TRI-VALLEY E. A.TRI-VILLAGE E. A.TRIWAY E. A.TROTWOOD MADISON E. A.TROY CITY E. A.TROY CITY S.S.A.TRUMBULL CAREER & TECH E.A.TRUMBULL CO BOARD CLSFD S ATRUMBULL CO BOARD PROF S.A.TUSCARAWAS VLY T. A.TUSLAW C.T.A.TWINSBURG E. A.TWINSBURG S.S. OEA-NEATWIN VALLEY A.C.T.UNION LOCAL E.A.UNION SCIOTO E. A.UNIOTO SUPPORT ASSNUNITED E. A.UNITED RIVERSIDE E.A.UPPER ARLINGTON E. A.UPPER SANDUSKY E. A.UPPER SANDUSKY S.S.UPPER SCIOTO VLY T. A.URBANA A.C.T.VALLEY T. A.VALLEY VIEW C.T.A.VAN BUREN E. A.VANDALIA BUTLER E.A.VERMILION T. A.VERSAILLES E. A.VINTON LOC T. A.WADSWORTH E. A.WADSWORTH SUPPORT STAFFWALNUT TWP E AWAPAKONETA CLASSIFIED ASSNWAPAKONETA E. A.WARREN E. A. - TRUMBULLWARREN LOC. E. A.WARREN SECRETARIAL ASSN.WARRENSVILLE E.A.WASHINGTON CENTERVILLE LBRY S AWASHINGTON CO CAR CNTR T.A.WASHINGTON E. A. - FAYETTEWASHINGTON LOCAL C.T.A.WATERLOO E. A.WAUSEON E. A.WAVERLY C.T.A.WAYNE COUNTY J.V.S. E.A.WAYNESFIELD-GOSHEN E.A.WAYNESVILLE E.A.WAYNESVILLE NON CERT E.A.WAYNE TRACE E.A.WEAVER E.A.WEAVER WORKSHOP SUPT ASSNWELLINGTON E. A.WELLINGTON S.S.P.WELLSTON T. A.WELLSVILLE T.A.WEST BRANCH CLSFD EMP ASSNWEST BRANCH E. A.WEST CARROLLTON CLSFD E.A.WEST CARROLLTON E. A.WEST CLERMONT E.A.WEST CLERMONT HOPEWESTERN BROWN E.A.WESTERN BROWN SCH EMP ORGWESTERN LOCAL E.A.WESTERN RESERVE E.A.WESTERVILLE E. A.WESTERVILLE EDUCATION S S AWESTFALL E. A.WEST GEAUGA E. A.WEST JEFFERSON E. A.WESTLAKE T. A.WEST LIBERTY SALEM E. A.WEST MUSKINGUM E. A.WEST MUSKINGUM SUPPORT ASSNWHEELERSBURG E. A.WHITEHALL E. A.WICKLIFFE E. A.WILLARD E.A.WILLIAMSBURG E. A.WILLOUGHBY-EASTLAKE CLSFDWILLOUGHBY-EASTLAKE T. A.WILMINGTON E.A.WINDHAM T. A.WINTON WOODS T.A.WOLF CREEK LOCAL E. A.WOOD LANE E.A.WOODMORE E. A.WOODRIDGE E. A.WOOSTER E. A.WORTHINGTON CLSFD ASSNWORTHINGTON E. A.WYNFORD E.A.WYOMING E. A.XENIA CAFETERIA STAFF ASSNXENIA E. A.XENIA EDUCATION SUPT PROF.YELLOW SPRINGS E. A.YOUNGSTOWN E. A.YSU-ACEYSU A OF PROF ADMIN STAFFYSU CHAPTER OF OEAZANESVILLE E. A.ZANE TRACE E. A.ZANE TRACE S.S.P. ASSN.OEA District(Required)CapitalCentralECOEAEOEANCOEANEOEANWOEASEOEASWOEAWOEAMailing Address(Required) Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Email Address (must be non-work email)(Required) Phone Number(Required)Gender(Required)FemaleMaleNon-binary/Gender Non-ConformingTransgenderPrefer not to answerEthnicity(Required)Asian and Pacific IslanderNative American/Alaskan NativeLatin (o/a/x), Hispanic, Chicano (o/a/x)Black or African AmericanMultiracialMiddle Eastern North AfricaWhiteOtherPrefer not to answerNumber of years in Education(Required)0-3 years4-6 years7-9 years10-24 years25+ yearsMembership Category(Required)Active Professional (K-12)Aspiring EducatorEducation Support Professional (ESP)Healthcare or Public Service EmployeeHigher Ed.RetiredLeadership Level(Required)Activist/Emerging LeaderRecently-Elected Association LeaderExperienced/Seasoned LeaderAre you able to take leave from work to attend this event?(Required)YesNoHave you previously attended the NEA Leadership Summit?(Required)YesNoHow were you funded to attend?OEANEASelf-fundedAre you under age 35?(Required)YesNoWho, if anyone, recommended you for this program? Please provide a short paragraph explaining your interest in attending and how the NEA National Leadership Summit will benefit your local association, district, and OEA.(Required) Δ
