UCAE Membership Renewal Form

You may either pay with Paypal or complete this form, then print for mailing with your check for membership.

Please mail the renewal form and check to:

UCAE c/oSchool of Visual Arts,
MAT Art Education Department,
209 East 23rd Street, NY, NY 10010

Dues: Student: $35 Individual: $60 ($20 of which goes to UCAE Fund*) Institutional-up to 3 members: $100 Life Membership $500

* The UCAE Fund was established in 2001 to support exemplary art education. Contributions are fully tax deductible.

Title (Mr., Ms,. Dr.)

Name:

First

Last

Preferred E-mail Address:

Today's Date:

day

month

year

Home Address:

Street AddressStreet Address Line 2CityState / Province / RegionPostal / Zip Code

Professional Affiliation

Department:

Academic Rank or Title

Work Phone:

Area Code

Phone Number

I would like to recommend the following visual arts leader(s) or institution(s) for membership [include contact information]:

Comments, suggestions, and recommendations for future UCAE activities:

Pay Pay Payment for:

OR Print and Mail this form with a check

My check (payable to UCAE) is enclosed in the amount of: