Become an AzCAN Member!
Are you representing yourself or an organization?
I am representing myself
I am joining as an organization
Individual membership questions
First Name
Last Name
Professional Title
Organization
Address
Address 2
City/Town
State
ZIP Code/Postal Code
Email
Phone Number
How would you like to be involved with AzCAN? Check all that apply
Volunteer with AzCAN or member organizations
Utilize AzCAN Standards and Data
Participate in professional development
Attend events
Support events
Support advocacy and statewide initiatives
Other
Membership registration questions
Organization Name
Street Address
City/Town
State
ZIP Code/Postal Code
Phone
Organization website
Brief description of your program or organization
What is your organization/program best classified as?
Community organization
College/university
High school/school district
Foundation
State agency
National organization
Other
Which region of the state do you serve?
North
Central
South
Statewide
Does your organization/program provide direct services to students?
Yes
No
If yes, indicate the major services the program provides. Check all that apply
Academic enhancement
Advanced curriculum
Career exploration
College fairs and/or visits
Fee payments for tests, admissions
Financial aid advising
Leadership skills
Mentoring
Scholarships
Test preparation
Other
What are the AzCAN Standards addressed by your program? Check all that apply
Building college and career aspirations
Academic preparation
Developing a support system
Cultural and emotional success factors
College knowledge
Financial literacy
Developing persistence
How many students do you serve annually?
What target population does your program serve? Check all that apply
Low-income
Low- to mid-level academic performance
Minorities
ESL students
First-generation college goers
Students with disabilities
Out-of-school youth (drop outs)
Foster youth
Homeless students
Elementary students
Middle school students
High school freshmen and sophomores
High school juniors and seniors
Postsecondary students
Adults
Active duty military or veterans
Other
What areas of college access or success would you like to enhance or develop in order to make your program better? Check all that apply
Social media
Using technology to improve services
Engaging parents
Collaborating with partners
Marketing and communication
Curriculum development
Grant writing
Advocacy
Data and evaluation
Business/strategic planning
Other
What areas of expertise can you share with other AzCAN members? Check all that apply
Social media
Using technology to improve services
Engaging parents
Collaborating with partners
Marketing and communication
Curriculum development
Grant writing
Advocacy
Data and evaluation
Business/strategic planning
Other
PRIMARY CONTACT/USER INFORMATION
First Name
Last Name
Title
Email
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