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Membership Application Form

bullet Membership Benefits

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

Name:
Mailing Address:
Mailing Address 2:
City:
State:
Zip:
Home Phone:
Work Phone:
Fax:
e-mail:
Employer/School:
Population:
Certification(s):
 CTRS other:


Membership Fees:

                                   1 year              2 years

Professional            $55             $100
Associate                $50             $  90

Provisional Prof.     $30              N/A
Student                   $30             $  50            
Retired                    $25             $  40 

Organizational        $125           $240

-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: $


Please send application and 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)

 

 

 

 
 
 
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