2026 - 2027 Membership Application - Check/PO Only

To apply for ConnCASE membership, please complete the form below.

Please note: Be sure to select the region where your school is located, as members can only attend regional meetings in their school's region.

See our map to determine your local region
Learn more about our membership categories

(* Denotes Required Fields)

Membership Selection

Membership Type: *

New Renewal

Membership Category: *

Active Membership (+$250.00) Associate Membership (+$150.00) Retired Membership (+$60.00)

Note: Regional dues are INCLUDED in your ConnCASE membership.

Member Information

Name/Title: *

School: *

Address: *

Telephone: *

Fax:

Email Address: *

ConnCASE Region # (ADD # NOT STATE): *

Mentorship Program

Are you interested in the Mentoring Program?: *

Yes, I am interested in being a Mentor Yes, I am interested in being a Mentee No, not at this time

Mentor Requirements: In your current position for a minimum of 3–5 years and MUST be at the Director level.

Mentee Requirements: In your current position for a minimum of 2 years or less and MUST be at the Director level.

Pay By Check or Purchase Order

Pay by Check:

Pay by Check Pay by Purchase Order

If you choose to pay by check or purchase order, your membership is not active until payment is received. You can email info@conncase.org with a copy of your purchase order for processing.

Connecticut Council of Administrators of Special Education
P.O. Box 1381
Glastonbury, CT 06033
Tel. 860.710.8197
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