PCTELA Membership Application
PENNSYLVANIA COUNCIL OF TEACHERS OF ENGLISH AND LANGUAGE ARTS MEMBERSHIP APPLICATION

Annual Dues

$25 for a TWO year period

$5 Student Membership (ONE year)

Only use this form if paying via PayPal. If sending a check, please print a copy of the application and mail it with your check.
Last Name *
First Name *
Address 1 *
Students: please use your home address, not your school address.
Address 2
City *
State *
Zip *
Email *
Professional Status *
Level *
Institution
Institution Address 1
Institution Address 2
Institution City
Institution State
Institution Zip
Phone Number *
Please enter in the following format: xxx-xxx-xxxx
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