8309 Fairhaven Lane
Montgomery, Alabama
36117
ACTE Membership Application
Check Here: _____ Individual (adult -$10.00; student - $5.00)
_____ School (Partnership Plus) ($50.00) (please list principal as member-contact)
Name______________________________________________________________
School Name __________________________________________________________
School Address (street, city, zip)
__________________________________________________________________
School Phone ______________________ School Fax _____________________
School E-Mail _____________________ School WWW Homepage URL
________________________________ _______________________________
Home Address (street, city zip)
__________________________________________________________________
Home Phone _________________ Personal E-Mail_______________________
Send Mail to: ________School _______Home
(Please see other side to check interest areas)
Professional Specialty: __________________________________________________
Job Title: _____________________________________________________________
Are you a current ACTE member? _____Yes _____No
ACTE Membership
PO Box 4637
Montgomery, AL 36103-4637
Membership Category
____Teacher ____ Media Specialist ____Technology Specialist ____ Administrator
____Parent ____Student ____Vendor ____Business ____Other
If you are a teacher, student, media specialist, technology specialist or administrator:
_____K-8 _____9-12 _____Area Voc. _____District Wide
_____Community/Technical College _____Four Year College/University
_____Government Agency _____Business _____Other
Are you a current ACTE member? _____Yes _____No
Dues Schedule (Per Year)
Individual Membership $10.00
Student Membership $ 5.00
School Membership $50.00 for 1999-2000
($25.00 only if registered as a school member prior to July 1, 1999)
(for Partnership Plus purposes) (please list Principal on form above)
Total Enclosed ______________ (attach one form for each membership
ACTE Membership
PO Box 4637
Montgomery, AL 36103-4637