1 Start 2 Organisation Details 3 Payment 4 Complete Thanks for choosing to renew your membership. ASE Science Department Membership provides your department with resources and professional development opportunities designed to support Heads of Department, science teachers, technicians and trainees.and with out Science Department Membership you can have up to 5 users on your membership. On the checkout page you will be given the option to either check out via credit or debit card, or select an invoice. If needed you will also be able to input a Purchase Order Number. If you select invoice this will be emailed to the email address used on the form below. The invoice will be attached to the email confirmation of your details. Please fill out the form below to complete your renewal: Membership Type * Science Department (£250) Would you like to renew or add additional users? You get 5 users as standard, but additional users can be added for £30 per user. If you have additional users already you can renew that option below or you can add more users if needed - None -Yes How many users would you like to renew or add? - None -123456789 Select an Add On - None -Science Teacher Education Journal for Departments (£35) Would you like to renew a Professional Learning Membership to one of the members on your Department membership? Professional Learning Membership can be added to ONE member listed on the department membership for £50 and will allow this member access to ASE Futures Group and resources, Science Teacher Education Journal, and the opportunity to apply for one of our professional registrations. (Any other member on the membership wishing to apply will need to maintain being a full individual member to do so.) - None -Yes - Renew Professional Learning Membership (£50) Member Details - Professional Learning MembershipPlease fill in the details below for the member you would like to assign the Professional Learning Membership too. First Name Last Name Job Title Please select their/your ASE Region - None -Anglia (Norfolk and Suffolk) Berks, Bucks and OxonCymru WalesBeds, Herts and CambsLondonNorth East London & Essex (Essex, Waltham Forest, Barking and Dagenham, Newham, Havering and Redbridge)North East (Northumberland, Tyne and Wear, Durham)North & East Midlands (Nottinghamshire, Derbyshire, Leicestershire, Northamptonshire, Lincolnshire and Rutland)North West (Cumbria, Lancashire, Greater Manchester, Merseyside, Cheshire and Isle of Man)Northern IrelandScotlandSouth East (Kent, Bromley and Bexley)South West of England (Devon, Cornwall and Isles of Scilly)Southern Counties (Hampshire, Dorset, Isle of Wight, Channel Islands)Surrey & SussexWest Midlands (Herefordshire, West Midlands, Shropshire, Staffordshire, Worcestershire and Warwickshire)West of England (Bristol, Gloucestershire, Somerset, and parts of Wiltshire and Dorset)Yorkshire and the Humber (All areas) Your contact details Please fill out your details and these will be used to create your online account. First Name * Last Name * Email * Phone Number * Job Title * What are your areas of interest? * Primary ScienceBiologyChemistryPhysicsProfessional DevelopmentSENDSTEMLeadershipEducational ResearchTeacher Education11-19Science Education Policy Birth Date (Optional) Day Day12345678910111213141516171819202122232425262728293031 Month MonthJanFebMarAprMayJunJulAugSepOctNovDec Year Year19241925192619271928192919301931193219331934193519361937193819391940194119421943194419451946194719481949195019511952195319541955195619571958195919601961196219631964196519661967196819691970197119721973197419751976197719781979198019811982198319841985198619871988198919901991199219931994199519961997199819992000200120022003200420052006200720082009201020112012201320142015201620172018201920202021202220232024 Gender (Optional) - None -FemaleMaleOtherPrefer not to say Leave this field blank
