Graduation Ceremony: Temporary Membership Application

This Temporary Membership Application is only to be used by families joining MDHSA on or after January 1 for the express purpose of participating in the MDHSA Graduation Ceremony in June.

This Membership is limited to eligibility to participate in the MDHSA Graduation Ceremony; it does not include access to any other MDHSA programs or access to the secured section of the website.

Before completing the application…
Be aware that MDHSA was founded in 1986 as a Christian organization and has a Statement of Purpose and Faith. You do not need to subscribe to our religious beliefs in order to participate in our ceremony, but you should know that our ceremony will reflect those beliefs. Being Christians determines how we live and act. It is our purpose to be kind to everyone, and to ensure that material presented is not offensive in any way. For that reason, all presentations are previewed and may not be accepted at the discretion of our Executive Committee.

Read our organizational statements to determine your membership type.
There are two types of membership set forth in our Bylaws: full membership and associate membership. BOTH TYPES OF MEMBERSHIP ALLOW YOUR STUDENT FULL PARTICIPATION IN THE GRADUATION CEREMONY. In order to select your membership type, you must read the following organizational statements. If you fully agree with the beliefs contained in our organizational statements, choose a full membership. If you do not agree, choose an associate membership. Your choice is kept confidential.

Fill out the membership application below and submit the $25 temporary membership fee.
Once you complete the application, you will receive an email confirming receipt of your application. PLEASE SAVE THE EMAIL: It contains the link and password you need to access the Graduation Ceremony Registration Form. 

Parent Name *

First

Last

Additional Parent Name (if applicable)

First

Last

Please complete this field if both parents are residing at the same address and wish to apply for membership together.

Address *

Address Line 1

Address Line 2

City

--- Select state ---AlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState

Zip Code

Email *

Phone *

Can this phone number receive text messages? *

• Yes
• No

Alternate Phone (optional)

Membership Type *

• FULL: I have read and agree with all of the points outlined in the excerpts of MDHSA's Bylaws and Articles of Incorporation.
• ASSOCIATE: I have read and do not agree with the points outlined in the excerpts of MDHSA's Bylaws and Articles of Incorporation.

Signature *

By typing my name, I acknowledge that I am signing this application electronically and agree that my electronic signature is the legal equivalent of my manual signature on this application.

Today's Date *

If you have any comments or questions concerning this membership, please enter them here.

Temporary Membership Fee (for Graduation Ceremony) *

Price: $25.00

SubmitSave and Resume Later