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Educating and empowering members to provide healthy meals to foster an environment where children achieve overall wellness and lifelong success.
Regular Membership Application

Regular Membership Application

Please provide the following contact information:
First Name* Last Name*
Title
District/School*
Work Address
Work City Work State
Work ZipCode
Work Phone Work Ext.
Work FAX
Email*
Home Address
Home City Home State
Home ZipCode Hm Phone
SafeHuman
Referred By:
Preferred Mailing Address: *
Do not include my home information in the membership directory
Do not include any information of my in the membership directory
Do not include my email in the membership directory
Employer pays dues
Employed by:
Public School System
Private School System
Private management company
Subscription Categories Includes CSNA and Local Chapter Dues.  SNA dues is paid directly to SNA. - View Fees.  You will be given the link to join SNA as well, once you complete your CSNA and Local Chapter application.
(Please choose one)
Foodservice Employee $15
Foodservice Manager $20
Student $15
Retired $15
Foodservice Director/Supervisor $65**
   District Major City State Agency
Foodservice Educator $65**
Other (principals, etc.) $65**

Chapter ****
I would like to join an additional local chapter $5  
I would like to join an additional supervisory chapter $30   ***
    **Dues Allow you to join one regional chapter in place of a local regular chapter. You may choose Chapter 1, 2, 10, 20, 45
    ***$30 for regional chapters 01, 02, 10, 20 or 45


Voluntary California Child Nutrition Foundation Contribution $

Total 
Payment Type: Credit Card Type:
Credit Card Holder's First Name:
Credit Card Holder's Last Name:
Credit Card #:
Credit Card Expiration Date:  
CC V-Code:
CC Street Address:
CC Zip:

Comments:


If paying by check, please send payments to:
CSNA
PO Box 11376
Burbank, CA 91510

(We cannot process purchase orders, please make sure if paying by check the form is accompanied by the check.)

California School Nutrition Association
PO Box 11376, Burbank, California 91510
Phone: (818) 842-3040 | Fax: (818) 843-7423
President's Party Sponsors:
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