NATA Atrack New Student Member Application

Please complete the application in full and press the SUBMIT button at the bottom of this form. Please allow up to 3 business days for processing.

Personal Information

   
mm/dd/yyyy
   
(must include to receive receipt of your payment)
Have you been a member of NATA previously?
(if applicable)
Other:

School Information

 
 
 

Additional Demographic Information

For committee/volunteer work please indicate areas of interest or expertise

Please answer, under oath and penalty of disqualification: Have you ever been convicted of a felony?

Payment Information


Credit Card Information
(use mm/yyyy format)

Communication Preferences

Pricing Chart

I authorize to charge my credit card (or invoice my school) according to the following dues structure, based on my address [entered above].
StateAmount
AK, ID, MT, OR, WA$70.00
AR, IL, IN, MI, MN, OH, TX, WI$75.00
MD, NC, SC, VA, WV, Dist of Col.$78.00
AL, GA, FL, IA, KS, KY, LA, MO, MS, ND, NE, OK, SD, TN, Puerto Rico, Virgin Islands$80.00
DE, NJ, NY, PA $85.00
CT, MA, ME, NH, RI, VT$90.00
AZ, CA, CO, HI, NM, NV, UT, WY, Guam$105.00
By submitting this form using the button below, I adhere to the following statements:
  • By submitting this form,  I pledge to abide by NATA's bylaws, policies and procedures, membership standards, code of ethics, and other rules and regulations. View these documents online. I understand violations may subject me to disciplinary action as outlined in the Membership Standards.
  • Credit Card Disclaimer.  I authorize NATA to charge my credit card.  If I close this account prior to this indebtedness being satisfied, I will notify NATA’s membership department of the specifics of my new account or how the outstanding balance will be paid.  I understand that if I fail to meet my payment obligation to NATA, my membership will lapse.
  • Payments or contributions to the National Athletic Trainers' Association are not deductible as charitable contributions for federal income tax purposes. Payments may be deducted as a business expense. If in doubt, please consult your tax advisor. NATA will not discriminate against any individual on the basis of religion, sex, ethnic background, or physical handicap. 13.8% of dues are allocated for lobbying.