Online Form for Dual FFSE/ISTA Membership

Join Fermilab Friends for Science Education and the Illinois Science Teachers Association and receive a discount of $6.00.

Membership levels are:

• Fermilab Friends for Science Education (FFSE) Teacher Membership $10 (Use the FFSE Membership Form.)
• FFSE and ISTA Full Membership (ISTA normally $35) $39
• FFSE and ISTA Associate Membership (ISTA normally $15) $19 (for full-time students or retirees)
• FFSE and ISTA Institutional Membership (ISTA normally $75) $79
(includes two ISTA Spectrum subscriptions and membership benefits for up to three teachers)

For information on ISTA membership benefits go to www.ista-il.org.

If you prefer to print out the form and send a check, use the FFSE/ISTA Form.

Choose a membership level from the pull-down list. Fill out the rest of the form and click on "Subscribe."
Use the tab key to go between text boxes; the keystrokes,"Return" and "Enter," have been disabled to avoid submitting the form prematurely. If you have questions about the membership form, please contact ffse-fund@fnal.gov.

Membership Levels FFSE & ISTA Full Membership $39.00 FFSE & ISTA Associate Membership $19.00 FFSE & ISTA Institutional Membership $79.00 Name: Affiliation (School): School Address: City, State, Zip Code: E-mail and/or Fax: Day Phone: Home Phone: Home Address: Home City, State, Zip Code: County in Illinois:

Check Applicable Categories in Each Column:
Level	Subject	Position
Elementary Level Middle Level Senior High School Community College College/University Industry/Business/Govt. Other:	Elementary Sciences Life Science/Biology Physical Sciences Environmental Science Earth Science/Geology Chemistry General Sciences Integrated Science Other:	Teacher Administrator Physical Sciences Coordinator Librarian Student Retired Other: