Hawaii Science Teachers Association (HaSTA)

Membership Application Form (9/1/2007)

Membership Fee: Regular($20/year), Student ($10/year). Membership is from October to October.

It includes subscription to the Catalyst and no charge for semi-annual conferences/meetings.

NAME __________________________________________________________________________________

ADDRESS _______________________________________________________________________________

CITY / STATE /ZIP ________________________________________________________________________

ISLAND (circle): Hawaii Kauai Lanai Maui Molokai Oahu

SCHOOL / ORGANIZATION _______________________________________________________________

HOME PHONE ___________________ WORK PHONE _________________ FAX ___________________

EMAIL ADDRESS _______________________________________________________________________

· If you do not want your email address added to the HaSTA email listserve, check here _________

· If you do not want your name and email address released to interested organizations, check here _________

Area(s) of interest (circle)

Aerospace Biology Chemistry Earth Sci EdTech Marine Sci Physics Environment

Teaching level(s) (circle)

Elementary Middle School High School College/University Non-Formal Retired

Membership category (circle) new renewal

I would like to make a donation to HaSTA in the amount of $________(During the month of Sept.-2007 any

donation you make to hasta atany Foodland branch, will be matched by Foodland.) It's great for hasta!!!

Total amount enclosed $____________ Check # ____________ Bank ____________________________

Make check payable to : Hawaii Science Teachers Association

Mail check and completed form to: HaSTA Membership Committee

P.O. Box 61754

Honolulu, HI 96839

This application form can also be found at our website: www.hasta.us