ITE Membership Application Form

Complete the following form to become a student member of ITE.
Annual student dues are free for the first year and $20 each following year.

You must complete this form and turn in your dues to be an offical member.
Please turn in dues to the ITE Office in 135 More Hall. Make all checks payable to "UW ITE."

The form fields below in pink are required.
The form will not be accepted unless this information is provided.

(If your browser doesn't support forms, you can send e-mail with the information below directly to
ite@u.washington.edu. Or, you can visit the ITE Office in 135 More Hall.)

Name:

UW Student Number:

E-Mail Address:

Major

Phone Number:

Student Status: Undergraduate Graduate

Expected Graduation Date: TERM Autumn Winter Spring Summer YEAR 2008 2009 2010 2011 2012 2013 2014 Ouch

Is this a renewal application? No Yes

Are you a national ITE member? No Yes

Please feel free to write any questions/comments below: