NYSATE  2008-09 Membership Application
New York State Association of Teacher Educators

ID # Membership Type Expiration Date: Amount Due:

Mailing Address:   Home or business (list according to preference for correspondence from NYSATE)

Name

Address

City, Sate, Zip

Phone Email




PROFESSIONAL INFORMATION:
Employment:


Please Check:

I give my permission to NYSATE to share my information with others members for professional purposes.

Administration – Public/Private
Teacher – Public/Private
Administration – Higher Education
Faculty – Higher Education
Education Association (specify):
State Education Agency (specify dept.):
Other (specify):

   

PROFESSIONAL AREA:

Teacher – (specify Grade Level & Content Area):
Coordinator
Director of Field Experiences
Graduate Student
Undergraduate Student
Higher Education (specify Teaching Area & Research Area(s):

   

SPECIAL INTEREST AREAS

Please check area(s) of special interest you have

Personal Information

     Gender :            Female       Male

     Age Group :

     Under 35      35 – 44       45 – 55        55 & over

 

Collaborative Efforts
Exemplary Supervision Practice
Education Technology for Teaching and Learning
Science Education
In-service Education/Professional Development
Learning Styles
Mathematics Teacher Education
Multicultural Education
Social Studies Education
Early Childhood Education
Childhood Education
Middle School Education
Adolescent Education
Teaching students with disabilities
Higher Education Administration
Classroom Management
Teacher Induction
Language Arts Education
Research and Program Evaluation


Payment Information

     Membership Dues                 $ ________
           1 Year - $35
           2 Years - $65
           3 Years - $100
           Lifetime - $500
           Retired Membership - $10
           Student Membership - $10

     Voluntary Contribution            $ ________

     Total Enclosed:                       $ ________

     Please Make Check Payable to:
     New York State Association of Teacher Educators

     Please return completed form to:
      Debra J. Thomas
     NYSATE Vice President for Membership    
     Rockland Teachers' Center Institute
     65 Chapel Street
     Garnerville, NY 10923

Dues and contributions in support of NYSATE are tax deductible.