NAEYC Membership Application

Memberships must be in the name of an individual, not a center or school. Please print clearly.

Name ______________________________________________________________________________________
Address ______________________________________________________________________________________
City ________________________________________ State _________________ Zip ____________________
E-mail address__________________________________________________________________________________
Home phone ____ / ______________________________ Work phone ____ / _______________________________
Check one: ____ New membership ____ Renewal (ID# ________________________________________________ )
 

Choose the membership option best for you:

Choose Comprehensive, Regular or Student level. Check one of the six shaded boxes in the table below. Note: all memberships include a subscription to the journal Young Children. Comprehensive members receive additional publications.

NAEYC Affiliate Membership
Includes membership in NAEYC and California AEYC and San Francisco AEYC.

Affiliate Name/Number: San Francisco AEYC - Affiliate ID 12
  $110  Comprehensive Affiliate Member
  $280 Three-Year Comprehensive Affiliate Member (15% discount)
  $60 Regular Affiliate Member
  $153 Three-Year Regular Affiliate Member (15% discount)
  $35  Student Affiliate Member
  $89  Three-Year Student Affiliate Member (15% discount)

NON-U.S. Addresses: Add $30 to Comprehensive or $20 to Regular or Student dues. U.S. funds only.

Students only: Student ID #: _______________ College/University Name: ________________________________

Indicate your payment option:
_____ Check/money order (make check payable to NAEYC)
_____ Charge to VISA  _____ Charge to MasterCard ____ Charge to AMEX  _____ Charge to Discover
Charge Card # __________________________________ Expiration date __________________________________
Cardholder's name _________________________________________________________________________
Cardholder's signature _________________________________________________________________________

NAEYC occasionally rents its membership lists to promote products and services deemed of interest to our members; revenues support NAEYC programs and activities. Check here if you do not wish to receive such mailings. ____

Thank you!
PLEASE RETURN COMPLETED FORM WITH YOUR PAYMENT TO:
(Note: please use this address only for membership payments, not accreditation or book sales.)
NAEYC Membership
P.O. Box 97156
Washington, DC 20090-7156                  (Or fax to 202-328-2649)		  
SFAEYC WEB
Form valid through 8/31/05