NYSCATE Membership Application

Thank you for your interest in joining the New York State Association for Computers and Technologies in Education. Please complete the form below.

Already a member?  Click here to renew your membership.

Personal Information
Prefix:
First Name:
Middle Name/Initial:
Last Name:
Suffix:
Nickname:
Home Information
Home Address:
Home City:
Home State/Province:
Home Country:
Home Postal Code:
Home Phone:
Home FAX:
Employer Information
Employer:
Work Address:
Work City:
Work State/Province:
Work Country:
Work Postal Code:
Work Phone:
Work Fax:
Email
Email Address:
 Please do not share my email address
Alternate Email Address:
I would like to receive email from third parties  Yes
 No
Background Information
Job Title: Select the one that BEST describes your role:
Membership Type: Select one:
Content Area Represented:
(if applicable)
Select one: (optional)
How have you heard about NYSCATE? Select all that apply:

Other:
What other organizations are you affiliated with? Select all that apply:

Other:
Do you recommend, evaluate, specify or approve technology purchases?  Yes
 No
Notes:
Enter the number below to continue to the payment page.
:8::3::9::2: