TAAE - Campus Membership Application / Renewal Form for 2017-2018

Membership Year is October 1st, 2017 Through September 30th, 2018.

Membership information will be published in the website Membership Directory
and will be used for all TAAE mailings.

Type of Application: - Required New Campus Renewing Campus
ISD Name: - Required
Campus Name: - Required
Contact First Name: - Required
Contact Last Name: - Required
Contact Title:
Campus Address1:
Campus City, State, Zip Code: ,
Campus Phone: - Required
Campus Fax:
Campus E-Mail: - Required
Campus Website:

Campus Membership Dues 1 - 10 Members -   $300.00
11 - 30 Members - $400.00
31 - 50 Members - $600.00

I hereby offer permission for TAAE to communicate electronically:

Enter PO Number if the Campus is to be billed. You will not be directed to online payment.
Enter Campus Purchase Order #:

All TAAE materials for Campus Memberships will be sent in bulk for school distribution to Campus address listed. Death / Disability Insurance program via TAAE will not apply to Campus Memberships.

Click here for information on the Low Cost TAAE Liability Program

Please enter All Member Names and Information

Last Name            First Name Teacher/Staff Campus Email Address

www.taae.org  ●  1-877-258-8223  or 1-877-ALT-TAAE
1306 A West Anderson Lane, Austin, Texas 78757