UTD Instructor Annual Membership Form

UTD Instructor Membership – Annual

Please use the form below for your annual UTD instructor membership. Choose Recreational or Technical instructor. If you are a UTD recreational instructor but also teaching Essentials of Tech, please choose Technical Instructor.

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UTD Instructor Membership Form - Annual

Name(Required)

First Last

Email(Required)

Phone(Required)

UTD Instructor Number (if known)

Mailing address EXACTLY AS IT SHOULD BE ON THE ENVELOPE for your c-card mailed from the U.S.(Required)

Annual UTD Instructor Membership

Recreational Instructor, $200

Technical Instructor/IT (or Rec instructor plus EOT), $250

Credit Card

Card Details

Cardholder Name