Oregon and National ACTE Membership Application

Please enter the information below, print, and mail application to:

Thelma Clemons, Executive Secretary
2814 Dahlia Lane
Eugene, OR 97404

If you have questions about dues or membership categories link to the National site http://www.acteonline.org/join.aspx or e-mail  or phone the Oregon office (541) 668-8774..

(Please type or print legibly)
Name (first, middle, last)  
Last four Digits of
Social Security #
Home Address
City / State / Zip  / /
Telephone  Office  Home  
Fax Fax  
Email

PLEASE PROVIDE THE FOLLOWING INFORMATION

Position Title (Select  One)     

Institution Title (Select One) 

 F- Other 

ACTE MEMBERSHIP (Choose one) 

PROFESSIONAL MEMBERSHIP $60

STUDENT MEMBERSHIP $10
RETIRED MEMBERSHIP $31 INTERNATIONAL MEMBERSHIP $60

ACTE DIVISION MEMBERSHIP
Your ACTE membership dues include membership in ONE division; please make your division choice below.
Administration (ADM) Adult Workforce Development  (AWD)
Agricultural Education (AGR) Business Education (BUS)
Career Academy Family and Consumer Sciences Education (FAM)
Guidance and Career Development (GUI) Health Science Technology Education  (HEA)
Marketing Education (MAR) Special Needs (SPE)
Engineering and Technology Education (TGY) Trade and Industrial Education  (TRA)
NRS - New and Related Services - Must choose a section not the division
Cooperative Work Experience (WWB) Instructional Materials (WWC)
Integration of Academics & Career & Tech Ed (WWF) International (WWI)
Makers of Policy (WWH) Other (WWK)
Professional Development (WWD) Public Information (WWE)
Research (WWG) School-to-Work/Careers (WWN)
Support Staff (WWJ) Tech Prep (WWM)

Teacher Educators (WWO)

Safe Schools (WWP)
Additional division memberships are $10 each. Please type in the 
additional divisions you would like to join:
DUES SUMMARY:  Enter amount of dues for each category dues summary 
National ACTE Dues
ACTE Additional Division Dues
State Membership and State Division Dues
TOTAL DUES
METHOD OF PAYMENT
  Check      Purchase Order (Must be attached)
  Discover   MasterCard    Visa   American Express
Credit Card #
Expiration Date MM DD YY
Card Holder's Name
Card Holder's Zip Code


Date  MM DD YY

 


__________________________________                 
Signature                 

For information about our organization contact President: Mark Wreath
or Executive Secretary: Thelma Clemons

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Webmaster: Len Eaton lene@clackamas.edu

Last updated: July 1, 2009