| Date |
New |
Renewal |
| Regular |
Adjunct |
Retired |
Student |
| 1 year |
$30 |
1 year |
$20 |
1 year |
$15 |
1 year |
$15 |
| 2 year |
$55 |
2 year |
$35 |
|
|
|
|
| 3 year |
$80 |
3 year |
$50 |
|
|
|
|
| First Name |
Last Name |
| School or
Agency |
| Position |
| Mailing
Address |
| City |
State |
Zip |
| Home Telephone |
Work Telephone |
| Fax |
Email |
| Current
IATE Service |
| |
| Current
ATE Service |
| |
| Current
Interests: Areas you would consider in serving IATE: |
| |
Making a
conference presentation |
| |
Serving
on the Conference Review Committee |
| |
Serving
on the Conference Planning Committee |
| |
Writing
a journal article |
| |
Serving
as a journal referee |
| |
Serving
on the Legislative Committee |
| |
Serving
on the Membership Committee |
| |
Serving
on the Research Committee |
| |
Helping
with the newsletter |
| |
Serving
on the Executive Council |
| Activities
you would like to see IATE undertake |
| |
| |
| |
| Colleagues
you would recommend to the Nominating Committee for the Executive Council |
| |
| |
| |
| Please
send this form with a check payable to IATE to: |
| Dr. Ed
Pultorak, Executive Director, 911 Donnie Court, Joliet, IL 604355-4443 |