Illinois Art Education Association

Leadership for the Advancement of Excellence in Art Education

Renew your IAEA Membership TODAY!
Illinois Art Education Association
2010-2011 Membership Form

Membership year: Oct. 1, 2010 to Sept. 30, 2011

Name:
Mailing Address/Home:
City:
State:	Zip:
Select Your Region: Click here if you are not sure what region you are in
School Name:
School/Work Address:
City:
State:	Zip:
Home Phone: --	Work Phone: --
Fax:	Email:
I understand that my name will be published in the IAEA directory. In addition, I give permission for my address, telephone/email and division to be published in the membership directory. Please Check: Yes No
Please check your job level status: Elementary Middle Level Secondary Higher Education/Community College Administrative/Supervisor Museum Education Friend of IAEA
Membership Type: Renewal New
Membership Dues: Regular 1-Year Membership (dues $40) - (October 1 - September 30) Regular 2-Year Membership (dues $75) Student (dues $15) - required: submit a copy of current school ID or class schedule to verify fulltime student status to StudentMember@ilaea.org Retiree (dues $25) Retiree 2-Year Membership (dues $45) Friend of IAEA (dues $40)
Donations made in addition to membership are tax deductible according to tax laws. Donations to the IAEA General Fund to support promotion of art education programs Donation Amount: Donations to Student Scholarship Fund Donation Amount: