Date______________

New England Association of Chemistry Teachers

MEMBERSHIP AND RENEWAL FORM

(membership is good through June 30)

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Annual Dues: $25.00 Checks payable to: NEACT

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Newsletters will be sent via email unless you specifically request to have them sent by US Post.

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Return this form with your check to:

Jerusha Vogel, NEACT Membership Secretary

45 Dirksen Dr

Wilton, CT 06897

Home phone (203) 761-8587