IASCE Membership Application

To become a member of IASCE, fill out the form below. You can mail the form, along with a check or money order, to the address at the bottom of this page. If you prefer, you can fax the form, with the requisite credit card information, to (207) 685-4455, or you can e-mail the form by clicking the "Submit" button at the bottom of the page.

If you are applying for more than one membership, please submit a separate form for each membership desired.

Name
Address

City
State/Province
ZIP/Postal Code
Country
E-mail
Telephone

TYPE OF MEMBERSHIP

Basic Individual Membership (receiving newsletter electronically):
$20 (one yr) $35 (two yrs) $50 (three yrs)

Basic Individual Membership (receiving newsletter by post):
$30 (one yr) $55 (two yrs) $80 (three yrs)

Institutional Memberships (you will receive the newsletters by post):
$35 (one yr) $65 (two yrs) $95 (three yrs)

METHOD OF PAYMENT
Check      Money Order      Credit Card
(Please remit checks or money orders in U.S. funds.)

Credit card

Number

Expires

MAIL
IASCE - Cooperative Learning
ATT: Kathryn Markovchick
P.O. Box 390
Readfield, Maine 04355

FAX
(207) 685-4455
Country Code 001



Thank you for your interest in IASCE membership!