Membership Application
Form
NOTE: If you have
already registered in our free online National Tai Chi Instructors database
at http://www.AmericanTaiChi.org, here you ONLY need to provide
your name, city and state; you can skip all other information and proceed
to the reverse side.
First Name: ___________________________________Last
Name: _____________________________________
Middle Name: _________________________________
Affix:
______________________________
Mailing Address Line1:
_________________________________________________________________________
Mailing Address Line2:
_________________________________________________________________________
City: _________________________________________________
State: _________________________________
Zip Code: ________________________________Phone:
__________________________________
FAX: ___________________________________Email:
______________________________________________
Web URL: ___________________________________________________________________________________
Specialized
Styles
(check all that apply)
Applications
of Tai Chi (check all that apply)
Education/Degrees
(related to Medicine, Healthcare, Tai Chi, Physical Education, Oriental
Medicine):
________________________________________________________________
School: ____________________________________________________
Graduate Month/Year ___________________
The Year You Started
to Practice Tai Chi: _________________________________________________________
Membership
at Other Organizations
____________________________________________________________________________________________
(Proceed
to the other side for payment information)
Survey
Please help us serve you better by filling
this survey.
(The more you desire, the higher the
score. 1 -- the least desired; 5 -- the most desired.)
Desired
benefits to professional members
1
2
3
4
5
Personal liability
insurance or occupational accident insurance
Discount on profession-related
goods and services
Education Resources
on developing professional knowledge and skills
Information about how
to start/run Tai Chi schools and classes, including issues in management,
accounting, marketing, and business development
Professional conferences
and events
Help with marketing
and finding clients (fitness centers, corporate programs, hospitals,
etc.)
Help with job placements
(either help your school find qualified Tai Chi instructors or help
you find job at certain Tai Chi schools)
How did you hear about ATCA and its websites
(if you have comments, please attach additional paper)
_________________
___________________________________
Regular
Membership Fee:
Premium
Professional Membership: one year – $80 ortwo year
– $140
Professional Membership:
one year – $60 ortwo year – $100
Associate Membership:
one year – $35 ortwo year – $60
Two ways to submit
your application:
Mail: make your
check or money order payable to American Tai Chi Association, then mail
your application to:
American Tai Chi Association
2465 J-17 Centreville Road, # 150
Herndon, VA 20171
On the Internet: go
to http://www.AmericanTaiChi.org and submit your application
online through the secured payment system from (It is NOT necessary
for you to create a PayPal account to use its system).
* Required fields
http://www.AmericanTaiChi.org
2465 J-17 Centreville
Road, Suite 150, Herndon, VA 20171 Email: member@AmericanTaiChi.net