NSDA Power of ONE New Member Form Thank you for taking part in our Power of ONE campaign. We're excited about your potential membership. Please fill out the form below. By filling this out, you certify that you are a designated representative of the school in question who will serve as the responsible party (advisor) for that NSDA program, and that the administrator named below approves this petition for membership. Your Name* First Last Your Email* Official School Name*School Level*High SchoolMiddle SchoolState*--select one--AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWYPreferred NSDA District (if known)(applicable to high schools only)--select one--Deep South (AL)Arkansas (AR)Arizona (AZ)Big Valley (CA)Calif. Coast (CA)Capitol Valley (CA)East Los Angeles (CA)San Fran Bay (CA)Sierra (CA)Southern California (CA)West Los Angeles (CA)Colorado (CO)Colorado Grande (CO)Rocky Mountain - North (CO)Rocky Mountain - South (CO)Western Slope (CO)Florida Manatee (FL)Florida Oceanfront (FL)Florida Panther (FL)Florida Sunshine (FL)South Florida (FL)Georgia Northern Mountain (GA)Georgia Southern Peach (GA)Hawaii (HI)East Iowa (IA)West Iowa (IA)Idaho Gem of the Mountain (ID)Idaho Mountain River (ID)Inland Empire (ID)Greater Illinois (IL)Illini (IL)Northern Illinois (IL)Hoosier Crossroads (IN)Hoosier Heartland (IN)Northeast Indiana (IN)Northwest Indiana (IN)East Kansas (KS)Kansas Flint-Hills (KS)South Kansas (KS)Sunflower (KS)Three Trails (KS)West Kansas (KS)Kentucky (KY)Louisiana (LA)New England (MA)Chesapeake (MD)Maine (ME)Michigan (MI)Central Minnesota (MN)Northern Lights (MN)Southern Minnesota (MN)Carver-Truman (MO)Eastern Missouri (MO)Heart of America (MO)Ozark (MO)Show Me (MO)Magnolia (MS)Montana East (MT)Montana West (MT)Carolina West (NC)Tarheel East (NC)North Dakota Roughrider (ND)Nebraska (NE)Nebraska South (NE)New Jersey (NJ)New Mexico (NM)Golden Desert (NV)Sagebrush (NV)Hudson Valley (NY)New York City (NY)Eastern Ohio (OH)North Coast (OH)Northern Ohio (OH)Western Ohio (OH)East Oklahoma (OK)West Oklahoma (OK)North Oregon (OR)South Oregon (OR)Iroquois (PA)Pennsylvania (PA)Pittsburgh (PA)Valley Forge (PA)South Carolina (SC)Northern South Dakota (SD)Rushmore (SD)Tennessee (TN)Pacific Islands (TW)Central Texas (TX)East Texas (TX)Gulf Coast (TX)Heart of Texas (TX)LBJ (TX)Lone Star (TX)North Texas Longhorns (TX)South Texas (TX)Space City (TX)Tall Cotton (TX)UIL (TX)West Texas (TX)Yellow Rose (TX)Great Salt Lake (UT)Sundance (UT)Utah - Wasatch (UT)Virginia (VA)Puget Sound (WA)Western Washington (WA)Northern Wisconsin (WI)Southern Wisconsin (WI)West Virginia (WV)Hole in the Wall (WY)Wind River (WY)School Website URL*Total School Enrollment*School Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Home AddressComplete this section only if you’d like to use a home address as the primary mailing address for your school. Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country School Phone*Your Cell NumberBookkeeper Name (optional) First Last Bookkeeper Email (optional) Principal / Head Administrator Name* First Last Principal / Head Administrator Email* How did you learn about the Power of ONE campaign?Referring Coach Name* First Last Referring Coach School*