New York State Career Schools

Coalition OF

NEW YORK STATE CAREER SCHOOLS

AN ASSOCIATION OF CAREER SCHOOLS OF POST SECONDARY EDUCATION SINCE 1945

MURIEL ADLER TERENCE ZALESKI PRESIDENT EXECUTIVE DIRECTOR

& SPECIAL COUNSEL

DUES FORM: July 1, 2011 - June 30, 2012

The Dues Base Is Computed On Your Gross Annual Tuition (GAT)

DUES BASE (GAT) DUES

$ 0 TO 249,000 $ 500.

250,000 TO 499,000 1,000.

500,000 TO 749,000 1,500.

750,000 TO 999,000 2,000 .

1,000,000 TO 1,499,000 2,500.

1,500,000 AND OVER 3,000.

Please complete the form below. You may either pay the full amount or pay in two 1/2 installments (1st installment due August 1; 2nd installment by February 1, 2012). Please add $25. with each payment if paying in two installments.

Fiscal Year 2011 - 2012 Dues Computation

1. Dues Rate Based on GAT ______

2. Branch Membership, # of Branches ___ @ $250 each ______

3. Two installment plan - add $25 if making a ½ payment. ______

4. Total Payment Enclosed ______

SCHOOL NAME: ______

Send to William Z. Cann, Treasurer, CNYSCS, Apex Technical School, 635 Avenue of the Americas, New York, New York 10011 Phone: 212-645-3300