American Association of Teachers of FrenchMailcode 4510, Southern Illinois UniversityCarbondale, IL 62901Phone: 618-453-5731; Fax: 618-453-5733E-mail: aatf@frenchteachers.org; Federal ID #: 38-1718689

Calendar Year 2014 (Jan. 1-Dec. 31) Fall 2013 issues + 2014 membership Calendar Year 2013 (Jan. 1-Dec. 31)

Name ____________________________________________________________________________________________(last) (fi rst) (middle)

Address __________________________________________________________________________________________(street)

_________________________________________________________________________________________________(city) (state) (zip + 4) (country)

Annual membership dues (see categories below)

Optional Items

Chapter Dues (see listing on next page ) AATF Chapter Name ___________________ +_______

Fall issues option (Sept.-Dec. of previous year) (+$20) +_______

Contribution to the AATF Fund for the Future +_______

Membership ID Card (+$1) +_______

Francophone Calendar 2013-2014 (+$20) +_______

Foreign/Canadian Members Only: If you would like to receive the National Bulletin in hard copy, add $20. +_______

Contribution to Joint National Committee for Languages +_______

Print subscription to Le Français dans le monde (2014 subscriptions not accepted after June 1, 2014)[6 issues ($75) or 6 issues or 2 Didactique “Recherches et applications” ($85) + on-line access]Electronic subscription to Le Français dans le monde on-line access only: subscribe at [www.fdlm.org] XXXXX

Total Payment enclosed = _______

Additional contact information (for offi ce use only)

Phone: ____________________________________ (Circle one: H W Cell)

E-mail: ______________________________________________________

School/Employer: _____________________________________________Checks should be made out to the AATF and payable in US$ on a US bank.

Teaching Level (Check one)1. FLES*2. Middle School3. Senior High School4. Community College5 College/University6. Administration7. Private/Tutoring/Adult ed8. Jr. & Sr. High School9. Non-teaching/Retired

Dues Categories:Regular Membership $55/yearForeign or Canadian resident $65/yearFamily Membership $82/year (non US resident $92)Student $27/year (non US resident $37)

(proof of student status or advisor signature required with this form)

Send this form with annual membership fee for the calendar year selected above to the AATF. If card billing address is diff erent from above, please add.Bill my credit card: __________Security codeCard number: __________________________________________________Cardholder’s name: _______________________________ Exp. date ______Please see the chapter listing on the next page. If you would like to join an AATF chapter, please indicate it above and add the appropriate chapter dues, if any.

For offi ce use:

DATE _____________________

AMT _____________________

CHKN _______________ P S MO

HIST FST YR ________________

HIST CHAP _________________

AATF Chapters and Dues for 2013 Membership Year

CHAPTER DUES ZIPCODE RANGE CHAPTER DUES ZIPCODE RANGE

01 ALABAMA $5 41 SUFFOLK NY $5 117

02 ARIZONA $5 42 WESTCHESTER NY $5 105-109

03 ARKANSAS $5 43 WESTERN NY $5 140-144

04 NORTHERN CALIFORNIA $3 936-969 44 NORTH CAROLINA 0

05 SAN DIEGO 0 920-922 45 NORTH DAKOTA 0

06 SOUTHERN CALIFORNIA $8 900-935 46 OHIO 0

07 COLORADO-WYOMING $5 47 OKLAHOMA 0

08 CONNECTICUT $7 48 OREGON $3

09 DELAWARE $5 177-179 49 CENTRAL PA 0 166-169

10 FLORIDA $10 50 LEHIGH VALLEY $5 180-181

11 GEORGIA $5 51 NORTHEASTERN PA 0 182-187

12 HAWAII 0 52 PHILADELPHIA $8 189-194

13 CHICAGO/ NORTHERN IL-LINOIS

0 600-615 53 WESTERN PA $2 150-165

14 DOWNSTATE ILLINOIS 0 616-629 54 SUSQUEHANNA PA $4 170-176

15 INDIANA $5 460-479 55 RHODE ISLAND 0

16 NORTHWEST INDIANA $2 463-466 56 SOUTH CAROLINA $1

17 IOWA 0 57 TENNESSEE 0

18 KENTUCKY $7 58 HOUSTON $10 770-775

19 LOUISIANA 0 59 NORTH TEXAS $5 750-763

20 MAINE $5 60 CENTRAL TEXAS $5 767-787

21 MARYLAND $3 62 UTAH 0

22 EASTERN MASSACHUSETTS $5 014-027 64 VIRGINIA $3

23 WESTERN MASSACHU-SETTS / VERMONT

0 010-013 65 WASHINGTON AB BC AK $5

24 DETROIT 0 480-482 67 WEST VIRGINIA $6

25 MICHIGAN 0 483-499 68 WISCONSIN 0

26 MINNESOTA $3 69 IDAHO 0

27 MISSISSIPPI 0 70 EL PASO $3 790-799

28 GREATER KANSAS CITY 0 640-652 72 SOUTH TEXAS $5 755-777

29 GREATER ST LOUIS 0 630-637652-658

73 SOUTH DAKOTA 0 767-787

74 NEBRASKA 0

31 KANSAS $3 75 NEVADA 0

32 NEW HAMPSHIRE $5 76 NEW JERSEY $5

33 NEW MEXICO $5 77 NORTHERN VIRGINIA / DC 0 220-223

34 CENTRAL NEW YORK 0 130-139 78 HAUTES PLAINES TX 0 794-797

36 HUDSON VALLEY NY 0 120-129 96 COMPLIMENTARY/EXCH 0

37 METROPOLITAN NEW YORK $5 100-117 97 AT LARGE, CANADIAN 0

38 NASSAU NY $10 105-118 98 AT-LARGE, FOREIGN 0

39 PAYS DU NORD 0 129-136 99 AT-LARGE, DOMESTIC 0

40 ROCHESTER NY 0 144-146