Fields marked with an asterisk (*) are required.
CREDIT CARD PAYMENTS ONLY (use the paper application below for other payment types)
If you are a CURRENT IACTE MEMBER, please login and use the Membership Renewal form.

If you would prefer to use a paper application, you may download the Adobe Acrobat version here.

Step 1:
Please fill in your biographic information below.

Title*:	Choose One... Dr. Mr. Mrs. Ms. Prof.
First Name*:
Last Name*:
Employer*: If not currently employed, please type "none"
Position*: If not currently employed, please select "Other"	Choose One... Administrator/Supervisor Counselor Other Retired Student Teacher Teacher Educator Teacher Supervisor
Address Line 1*:
Address Line 2:
City*:
County*:
State*:	Choose One... Alabama (AL) Alaska (AK) American Samoa (AS) Arizona (AZ) Arkansas (AR) California (CA) Colorado (CO) Connecticut (CT) Delaware (DE) District of Columbia (DC) Federated States of Micronesia (FM) Florida (FL) Georgia (GA) Guam (GU) Hawaii (HI) Idaho (ID) Illinois (IL) Indiana (IN) Iowa (IA) Kansas (KS) Kentucky (KY) Louisiana (LA) Maine (ME) Marshall Islands (MH) Maryland (MD) Massachusetts (MA) Michigan (MI) Minnesota (MN) Mississippi (MS) Missouri (MO) Montana (MT) Nebraska (NE) Nevada (NV) New Hampshire (NH) New Jersey (NJ) New Mexico (NM) New York (NY) North Carolina (NC) North Dakota (ND) Northern Mariana Islands (MP) Ohio (OH) Oklahoma (OK) Oregon (OR) Palau (PW) Pennsylvania (PA) Puerto Rico (PR) Rhode Island (RI) South Carolina (SC) South Dakota (SD) Tennessee (TN) Texas (TX) Utah (UT) Vermont (VT) Virgin Islands (VI) Virginia (VA) Washington (WA) West Virginia (WV) Wisconsin (WI) Wyoming (WY)
Zip*:	-
Is this a Business Address?*	Choose One... Yes No
Phone*:	( ) - ext.
Fax:	( ) -
Email*:
Confirm Email*:

Step 2:
Please select one IACTE membership type.*

	Active ($50)
	Associate ($200)
	Associate/Individual ($50)
	Life ($1000)
	Loyalty or Retired ($25)
	Student (full-time undergrad) ($17)

Step 3:
Would you like to make a CQVE contribution? If so, please enter the amount.*

Yes    No

$

Step 4:
Please select one or more affiliate membership(s) then, if applicable, select the desired subcategory.*

	IAVAT and NAAE Active ($145) Associate ($30) Student ($1)
	IBEA Active ($45) Retired ($10) Student ($5)
	ICCA Active ($20) Student ($2)
	ICTA Active ($70) Active and NCLA ($90)
	IFACSTA Active ($65) Active and NATFACS (ACTE members only) ($85) Retired ($15) Student ($5)
	IHOA Active ($30) Student ($0)
	ILAVESNP Active ($20) Student ($5)
	INRS Applied Academic ($25) Community Service ($25) Corrections ($25) Guidance ($25) Research and Development ($25) Support Personnel ($25) Workforce Prep (Tec Prep, JTPA, Apprentice, etc.) ($25)
	No Affiliate Active ($0)
	TEA of IL Active ($35) Loyalty or Retired ($20) Student ($15)

Step 5:
Please select one ACTE membership type.*

	Affiliated ($60)
	Loyalty or Retired ($31)
	Student ($10)
	No ACTE Membership ($0)

Step 6:
If you have elected to apply for an ACTE membership, please select at least one Division Affiliation then, if applicable, select the desired subcategory.**
**You get your choice of one division with your membership. Additional divisions may be selected at a cost of $10 each.

	Administration
	Agriculture
	Business Education
	Employment Training
	Family and Consumer
	Guidance
	Health Occupations
	Industrial Arts
	Marketing and Distributive Ed.
	New and Related Adult Education CBITS Cooperative Work Experience Instructional Materials International Makers of Policy Others Personal Development Public Information Related Subjects Research School-to-Work or Careers Support Staff Tech Prep
	Special Needs
	Technical
	Trades and Industrial

IMPORTANT: Please review all information before continuing. You will NOT have the opportunity to change your registration information once you have clicked the "Next" button.