MEMBERSHIP APPLICATION FORM
Please print out the application, fill it in, and mail it to us with your check
Please print all information
Member Name: _______________________________________________
Home Address: _______________________________________________
City: _________________________ State: ____________ Zip: _________
Tel#: (______) _____________ E-mail Address: ____________________
Level Taught (Elem, JHS, HS, College):___________________________
Job Description:
______________________________________________
(Classroom Teacher, Student Teacher, AP, Math Coord, etc....)
School Name: _________________________ District: _______________
School Address: ______________________________________________
City: _________________________ State: ____________ Zip: _________
Tel#: (______) _____________ School E-mail Address: _______________
Check one: ______ 1 yr. $12 _______3 yr. $30
Make checks payable to ATMNYC and mail to:
Evelyn Estrine