Aggie Educator Network (AEN) Membership Form
The final step for renewing or becoming a member of AEN is to complete the information requested on this form.  Thanks and Gig 'em!
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Email *
Please select the option that best describes you. *
First Name *
Last Name *
Middle Initial
(Optional)
Maiden Name
Birthday Month and Day *
MM
/
DD
TAMU Graduating Class *
Use four digits (for example, Class of '85 would be entered as 1985).  If you haven't graduated yet, enter the expected year for graduation.  If you do not hold a degree from TAMU, please describe your connection to the University.
Home Phone
include area code, ex. 555-123-4567.  If you don't have a home phone, just enter N/A.
Cell Phone *
include area code, ex. 555-123-4567.  If you don't have a mobile phone, just enter N/A.
Current Mailing Address (Street or P.O.) *
Enter City, State and Zip code separately below
City *
State *
Zip *
Organization/School District
Enter name of organization or school district (if applicable)
Campus or Agency
Enter name of school or agency (if applicable)
Subject/Grade Level
Enter the subject and grade level taught (if applicable)
Job Title
Would you be interested in a leadership position for AEN (i.e. board member, committee chairman, etc.). *
How did you hear about AEN? *
Check all that apply.
Required
Did you pay for your AEN membership with a PayPal account?
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