ELMLE Membership Application Form

Instructions:

• Please correct name and address.
• Indicate whether you want an Institutional or Individual membership.
• Institutional members: please take the time to fill in the section below.
• Return to ELMLE with payment.

 Address: _______________________________________________

 ______________________________________________________

 Home Phone: ___________________________________________

 Work Phone: ___________________________________________

 E-mail Address: __________________________________________

 Fax Number: ____________________________________________
 

[  ]  Institutional Membership Option: $270
 
 

• 5 issues of Middle School Journal *
• 1 issue of Bridge in the Middle *
• 4 issues of Target*
• Periodic issues of Midpoints*
• 3 monographs
• 1 research publication
• ELMLE resource directory
• Registration discounts for ELMLE and NMSA conferences
• Eligible to nominate and carries 4 votes to NMSA elections
• Eligible to nominate and carries 2 votes to ELMLE elections

1. _______________________________________________

 

 

2. _______________________________________________

 

 

3. _______________________________________________

 

 

4. _______________________________________________

 

 

[  ]  Individual Membership Option: $110 ($165 w/Additional Option)
 
 

• 5 issues of Middle School Journal
• 1 issue of Bridge in the Middle
• Periodic issues of Midpoints
• 1 monograph
• ELMLE resource directory
• Registration discounts for ELMLE and NMSA conferences
• Eligible to nominate and vote in ELMLE elections

[  ]  Additional Option: $55
• 2 issues of Research in Middle Level Education

Please print and complete the attached membership application, enclose U.S. check or money order, and mail to:

Dr. Richard B. Nielsen, Treasurer

Institution	Smith American School,
Institution Telephone	(49) 6783-5693 Fax: 6783-8874
E-mail	Rich_Nielsen@ccmail.odedodea.edu

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