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Complete Member Application

Fill out and submit the simple form below � and you can begin enjoying the many benefits of I Teach America immediately.

Please complete form below. Fields in red must be completed in order to process.



First Name
Middle Name
Last Name
Home Address 1
Home Address 2
City
State
Zip
Daytime Phone (999-999-9999):
Email
Please Re-Enter Email:


Teacher?	Yes No

If yes, number of years of teaching:

Currently Teaching?	Yes No

If no, why currently not teaching?	Retired Sabbatical Changed Career Can't Find a Teaching Job

Grades Currently Teaching? Select all that apply	Pre-School Elementary (1-5) Middle (6-8) High School (9-12) College Graduate None

School System Where Teaching? Select all that apply	Public Private Vocational Other
Biggest Concern as a Teacher?

	Yes, please subscribe me to ITA's email newsletter, Teacher's Toolbox, which I will receive typically via email weekly.
	Yes, please send me other periodic ITA member communications.
	Please don't send me any of the above.

Since your membership is an online membership, we communicate with you via email. The primary communications are through our member newsletters. Occasionally, we will send you a separate email communication, but please be assured that we are sensitive to your time and will not bombard you with email communications. Note that I Teach America will not sell your email address and personal contact information to third parties.

If you do not wish to receive our email communications, you can easily opt out by simply clicking "Member Communications Opt-Out Request" on the following page after you press "Submit."

If you have any questions or comments, please contact us at admin@iteachamerica.org or 614-497-4088. Thank you.

I Teach America
PO Box 882196
Port St. Lucie, FL 34988
Tel: 614-497-4088
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