OAEA Membership Form

1

Would you like to save your progress while working on this form?

You may select the disk icon at the bottom of each window beginning on the next page.

floppy disk

Questions? forms@ohioarted.com

2

Today I am... (Please choose 1 item.)* This field is required.

Purchasing a NEW membership or re-establishing a lapsed membership

RENEWING my current OAEA membership

3

OAEA Mission Statement Approval* This field is required.By selecting "yes" below, I agree to abide by OAEA's Mission Statement. (Review here: https://www.ohioarted.com/organizational-resources.html)

Yes

No

4

OAEA Non-Discrimination Policy Approval* This field is required.By selecting "yes" below, I agree to abide by OAEA's Non-Discrimination Policy. (Review here: https://www.ohioarted.com/organizational-resources.html)

Yes

No

5

Today's Date* This field is required.

Date

6

E-mail (Personal email is preferred.)* This field is required.Work email filters sometimes block our communications.

7

Name* This field is required.

First Name

Middle Name

Last Name

8

Maiden name (if applicable)

9

Optional: Please attach a professional headshot of yourself. (**By uploading your image here you give permission for OAEA to use your image for advertising, advocacy, etc. to both OAEA members and the general public )

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

10

Find your OAEA Region in the map below. Then continue to the next page.

11

Region* This field is required.

13

Home Address* This field is required.

Street Address

City

State

Postal / Zip Code

Country

14

County (Home Address)

15

Home/Mobile Number* This field is required.Please use XXX-XXXX format.

Area Code

Phone Number

16

School District/Business/Organization Name (if applicable)

17

Worksite (if applicable)

18

School/Business/Organization Address (if applicable)

Street Address

County

City

State

Postal / Zip Code

Country

19

Work Number (if applicable)Please use XXX-XXXX format.

Area Code

Phone Number

20

If you work in/with a school, how many years have you done so?

21

**Affiliate Members ONLY** __ Please type the name and emails for two additional members. Each OAEA Affiliate membership includes (3) memberships.

Email

First Name

Last Name

Member #2

Member #3

Member #2

Member #3

Email

First Name

Last Name

Email

First Name

Last Name

22

In what year did you join OAEA? (ex. 1985)* This field is required.Please make your best guess if you are not sure.

23

Have you received an OAEA Circa Award?* This field is required.

Yes

No

I'm not sure

24

Are you currently a Distinguished Fellow?* This field is required.

Yes

No

I'm not sure

25

How will you pay?* This field is required.**If you have already paid your dues this year and are only providing updated information, please select UPDATE.**

Check by mail

Credit Card

OEA dues

26

Please select your Membership level.* This field is required.(Choose your level from one of the numbers below).

My Bag

1

Active Membercurrent, full-time educator
$50.00Edit
Back
Emeritus/Retired Memberretired
$30.00Edit
Back
Pre-Service memberfull time student
$30.00Edit
Back
Associate Membersupporter of the arts
$50.00Edit
Back
Affiliate Memberinstitution or nonprofit organization (up to 3 individual members)
$105.00Edit
Back
Lifetime30+ years of OAEA membership
$205.00Edit
Back

Credit Card

First Name

Last Name

27

Membership level (OEA Dues or Check by mail)

28

Invoice ID

29

If you are paying by credit card or OEA dues, select the "submit" button below.

OR

If you are paying by check, go to your email after you submit this form.

Print your form answers from the email you receive.

Please send your form and send your check to:

Ashton Kelly
1443 Snowmass Road
Columbus, OH 43235

Then submit this form.