Membership Application
If you have login name and password, please login here to renew your membership. If you do not know your login name or you forget your password, please click here to request your login name & password to be sent to your email address automatically. If you still can not login, then please use this form to renew your membership.

Personal Information
* Login Name (email or one you create):
* Login Password (at least 6 characters):
* Retype Password:
* First Name:
Middle/Initial:
* Last Name:
* Gender:
* Birth Date: / /
* Home Address:
* City:
* State:
* Zip Code: -
* Home Phone:
Fax:
* Email:
Web Site:
Educator Type Teacher Elementary
Teacher Middle School
Teacher High School
Principal Elementary
Principal Middle School
Principal High School
Superintendent
Counselor
Curriculum Supervisor
Anti-Bullying Coordinator
College Professor
Dean
Retired
BCC Association Brookdale Student
Staff
Faculty
BCC ID


Annual Membership Fees

* Membership: Individual $45
Family $100
Sustaining $200
Dollar-A-Day $365
Life Installment $500
Life $2000
Brookdale Student
Partner
The membership you have selected will automatically renew.

 

Household Information

Security
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