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CAEYC Membership Form |
Please print out this application form, then fill it out, and
mail it (along with check payable to "NAEYC") to:
NAEYC Membership
P.O. Box 97156
Washington, DC 20090-7156
Or you may join online, using a credit card,
by going to NAEYC's Web Site (www.naeyc.org).
(Please print or type)
Name __________________________________________________________________
(First Name, Middle Name, Last Name)
Mailing Address __________________________________________________________
__________________________________________________________
City ______________________________________ State _____ Zip _______________
E-mail Address ___________________________________________________________
Home phone (____)_________________ Work phone (____)_________________
Affiliate Group Number 82
Please check: Comprehensive
.............................. $85 ___
Affiliate .......................................... $50 ___
Student
.......................................... $40 ___
Please choose the publication package below that best meets your professional needs:
□ Subscription to Young Children
□ Subscription to Teaching Young Children
□ Subscription to both - additional fee of $19.00
Renewal ______ (ID Number) ________________ New _______
Employment ___________________________________________
Name of College to verify student status:
______________________________________________________
College
Date mailed ____________________________
Indicate your payment option:
____Check/Money Order
____Visa
____Master Card
Card # ________________________________________ Expiration Date_____________
Cardholder's Name ________________________________________________________
Billing Address ___________________________________________________________
___________________________________________________________
Signature ________________________________________________________________
Questions or problems regarding this web site should be directed to CAEYC@ColoradoAEYC.org.