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中大西洋桃李中文教师学会 CLTA-Taoli Mid-Atlantic
Membership Application / Membership Renewal
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* Indicates required question
1. Last Name
*
Your answer
2. First Name
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Your answer
3. 中文姓名 (in Chinese Characters)
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Your answer
4. Email Address
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Your answer
5. Preferred Phone Number
*
Your answer
6. Mailing Address (including City, State, zip code)
Your answer
7. Membership Type
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Regular membership: $30, current practicing educators
Associate membership: $20, students
Associate membership: $20, retired educators
8. School / Institution / Organization
Your answer
9. City (of School/Institution/Organization)
Your answer
10. State (of School/Institution/Organization)
Your answer
11. Role / Title
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Your answer
12. If you are a practicing educator, what level do you teach?
Pre-K
Elementary school (K-5/6)
Middle school (6-8/7-8)
High school (9-12)
Community college
Four year college / university
Other:
13. Membership Payment Options
*
Membership fee effective one year till the end of the month when you join (Example: August 1, 2023 to August 30, 2024)
PayPal
Debit or Credit Card
Venmo
By check, payable to Taoli-Clema; mail to 78 Oakford Road, Wayne, PA 19087
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