To join NYSTRA, complete this form, print it out on your computer, and mail with a check to the address shown below.

original application renewal

Membership Fees:

-Professional members are required to include a copy of their current CTRS certification card with renewal

-Student members are required to include a transcript or letter from advisor as proof of full-time student status

For Organizational Membership (list 5 staff who are eligible to attend conferences and workshops at member-rates)

1.
2.
3.
4.
5.

Additional contribution: $

NYSTRA now accepts credit cards!

Please fill out the following if paying by credit card:

Please check one:  __Visa __MasterCard

Name as it appears on card: ___________________________________

Card Number: ____________________________________________

3-digit security code: ________________  Expiration Date: __ __ / __ __

By signing below I do hereby authorize NYSTRA to charge $___________ to the above Visa/MasterCard Account

Signature (required): ______________________________________Date: _______________

Please send application and credit card information or check, or money order payable to NYSTRA to:

NYSTRA
P.O. Box 179
Riverdale Station
Bronx, NY 10471

(please allow 6-8 weeks for payment to be processed)