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Governing MembershipGoverning Member Application

I. Contact Information

Name of Director: ________________________________________________________

Title (e.g. Executive Director, President): ________________________________________________________

Name of Institution: ________________________________________________________

Address: _________________________________________________

City: ___________________________

State/Prov.: ____________________

Zip/Postal Code: _____________________

Country: ________________________

Telephone: _____________________

Fax: _____________________

E-mail address: __________________________

Web site address: _______________________

Name, title of person completing application:

________________________________________________________


II. Profile

Staff

Number of full-time paid staff: ________________________
Number of part-time paid staff: ________________________
Number of volunteer staff: ________________________

Facilities

Gross building interior space: ________________________
Total interior exhibition space: ________________________
Measurements in _____ square feet _____ square meters

Financial

Total operating income*: ________________________
Total operating expenses*:________________________
Please indicate currency: ________________________

Attendance

Total on-site attendance*: ________________________

*please use data from your most recently completed financial year


III. Questions

1. A science center/museum is an organized and permanent not-for-profit institution, dedicated to increasing the public's understanding of science and technology, which provides exhibits, programs, and activities addressing a broad spectrum of scientific disciplines and topics. Science centers/museums show dedication to the use of informal learning methods and use a broad array of delivery techniques for science learning experiences while serving as a resource for a community's science education needs.

Using the characteristics defined above, does your institution identify itself as a science center/museum?

2. Does the science center/museum have not-for-profit status?

3. Is the science center/museum staffed and open to the public at least 1,800
hours per year and six days per week?

4. Is the science center's/museum's primary mission to increase the public understanding of science?

Please state the mission or append a copy of the mission statement.

5. Describe how the science center/museum achieves its mission.

6. Science centers/museums use a broad array of delivery techniques for science education learning experiences (experiential, tactile, and kinesthetic exhibits; participatory programs, hands-on activities; inquiry-based learning). Participatory exhibits and programs encourage visitors to experiment, to have hands-on experiences, to manipulate variables, to observe phenomena, and to ask "what-if" questions.

To what extent do the science center's/museum's exhibits and programs employ such visitor participation techniques?

7. Does the science center/museum offer exhibits, programs, and activities addressing a broad spectrum of scientific disciplines and topics such as physical sciences, natural sciences, mathematics, and technology? Please provide examples.

8. Describe how the science center/museum serves as a resource for its community. How does your institution ensure that all segments of your community are participating in the life of the center?


IV. Supporting materials and signature

Please send two copies of the following required materials for the ASTC Membership Department's review:

___ Most recently audited financial statement
___ Most recent newsletter
___ Visitors' guide with floor plan or map
___ Brochures and other descriptive materials about your institution's exhibits, programs, and facilities. Please include your most recently published Annual Report, if available.

ASTC's leadership is committed to the following Core and Strategic Values:

Core
Public understanding of science
Strength in collaboration
Joy of experiential learning
Superior service to members
Global perspective

Strategic
Quality, excellence, and innovation
Equity and diversity
Members strengthening their own communities
Proactive leadership
Urgency

Do you agree with and demonstrate a strong commitment to these values?
_____ Yes
_____ No

ASTC's Statement on Science

Science is a human endeavor that uses observations and experimentation to
develop explanations of the natural world. Scientific theories are grounded
in and compatible with evidence, internally consistent, and demonstrably effective
in explaining a wide variety of phenomena. Science is based on hundreds of years
of scientific observation and experimentation and many thousands of
peer-reviewed publications.

Does your organization agree with ASTC's Statement on Science?
____Yes ____No

On behalf of our institution, I affirm that, to the best of my knowledge, we meet the criteria of an ASTC Governing member.

Signature, President, Chief Executive, Director, or the equivalent:

_____________________________

Printed name, President, Chief Executive, Director, or the equivalent:

__________________________

Date:


ASTC reserves the right, in its sole discretion, and for any lawful reason, to reject any application for membership.

Please mail this application and your supporting materials to:

ASTC Membership, 818 Connecticut Avenue NW, 7th Floor,
Washington, DC 20006 U.S.A.

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