STEP 1: Personal Information

First Name:
Last Name:
Member ID:

STEP 2: Select Committees

Please check the appropriate box and complete the related experience question in Step 3, for each committee choice. Choices are limited to 3 committees.

Standing Committees
(3 Openings Each)

Committee on College Science Teaching
Committee on Coordination and Supervision of Science Education
Committee on High School Science Teaching
Committee on Informal Science Teaching
Committee on Middle Level Science Teaching
Committee on Multicultural/Equity Science Education
Committee on Preschool and Elementary Science Teaching
Committee on Preservice Teacher Preparation
Committee on Professional Development
Committee on Research in Science Education
Audit Committee
Committee on Awards
Committee on Budget and Finance
Committee on Nominations

Advisory Boards
(1-3 Openings Each)

Aerospace Advisory Board
Conference Advisory Board
Development Advisory Board
International Advisory Board
Investment Advisory Board
Journal of College Science Teaching Advisory Board
NSTA Reports! Advisory Board
Retired Members Advisory Board
Science and Children Advisory Board
Science Safety Advisory Board
Science Scope Advisory Board
Special Education Advisory Board
The Science Teacher Advisory Board
Urban Science Education Advisory Board

Panels
(3-5 Openings Each)

NSTA/Children's Book Council Joint Review Panel
New Teacher Academy Judging Panel
The Shell Science Teaching Award Judging Panel
Toshiba/NSTA Exploravision Judging Panel
Toyota TAPESTRY Grants for Teachers Judging Panel

STEP 3: Justify Committee Selections

What experience do you have that directly relates to the work of these committees?

STEP 4: Address Preference

Preferred Contact Address:	WorkHome
Publish Home Address:	NoYes

STEP 5: Work Address

School/Business:
Title: (e.g. 4th Grade Teacher)
Address 1:
Address 2:
City:
State/Province:
Zip:
Phone:	- - ext.
Cell Phone:	- -
Fax:	- -
Email:

STEP 6: Home Address

Address 1:
Address 2:
City:
State/Province:
Zip:
Phone:	- -
Cell Phone:	- -
Fax:	- -
Email:

STEP 7: Additional Questions

I plan to attend this year's National Conference in Philadelphia, PA

YesNo

I am currently serving on an NSTA committee, advisory board, or panel?

YesNo

If yes:	which committee:
	term expires:

I have served on an NSTA committee, advisory board, or panel in the past 6 years?

YesNo

If yes:	which committee:
	term expired:

Educational Experience
Include present position, dates, and previous positions

Characters Available

Education

Characters Available

Professional Background

Characters Available