The Iris Network®
Registration Form

Complete this form and then activate the SEND link at the bottom.

Yes, I want to join The Iris Network as an individual member. I understand that the cost is US$198.00 for the annual subscription. I understand that I can access The Iris Network through the Internet, the World Wide Web, or by dialing directly.

Name of your school, private group or project, if applicable:

Name and Mailing Address:

First, Middle Initial, Last (required):
Title or position:
Department:
Organization:
Street address (or P.O. Box Number):
City:
State or Province:
Zip or postal code:
Country:
Voice phone (required):
Fax phone:
Your e-mail address (required):
Name of Iris Moderator you have talked with, if applicable:

Please enter a brief self introduction, which you can change at any time after you log on:

Method of access (check one) (We're just curious; there is no difference in cost):

  1. I will dial directly, using The Iris Network as my Internet Service Provider (ISP), (or)
  2. I will be accessing The Iris Network through another ISP.

Method of payment (check one):

  1. Charge my fees to my credit card, (or)
  2. Invoice my organization for my fees.

Credit Card Information: (Call us at 703-243-6622 with your credit card information if you prefer not to send it over the network.)

Credit card type (check one): Visa, MasterCard, or American Express
Name on card:
Account number:
Expiration date:

Billing Address: (if your organization will pay your fees)

Purchase order number: if applicable
Name of person handling your accounts payable: Organization:
Street address or PO Box number:
City:
State:
Zip code:


Any special requests or other information you'd like to send us (such as that you are evaluating the possibility of using Iris as an online environment for your own group or organization):
To send your registration form.
If you've decided not to SEND your registration, you can return to the Iris Home Page.

To clear all input and begin again.


Iris Network for Teachers and Schools, Inc. (iris@iris.org)
(Phone us at 703-243-6622 if you have any questions.)