Membership Dues:

Individual…………………………....................	$ 20.00
Lifetime……………………………...................	$100.00

Membership Form:

Mail to:	Ann Donzella Owens
	8 North Tweed Blvd.
	Upper Grandview, NY 10960
Questions about ESSA: annydo@verizon.net ATT: ESSAQ

Please make your check payable to E.S.S.A (Please Print)

	Name ____________________________	School:____________________________
	Address __________________________	Address __________________________
	City _____________________________	City _____________________________
	State _________ Zip_______________	State _________ Zip_______________
	Email __________________________@_______________________
	Email: ________________________@schools.nyc.gov
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Circle one: .......New Membership .........Renewal

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Benefits of an E.S.S.A. Membership

NEW Web Site access
Saturday Science
Field Trips and Hands-On Workshops
Affiliation with the Science Council of NYC (SCONYC)
Affiliation with the National Science Teachers Association (NSTA)
Professional Development
Educational Materials

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How did you hear about ESSA? ______________________________________

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© Science Council of New York City (www.sconyc-ny.org)