Member Name

Name

Address:

Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country

2006 - 2007 TYPES OF MEMBERSHIP AND DUES AMOUNTS 

Please Choose One	Annual Dues	Total
Fellow, Associate, and Affiliate	$  180
Resident	$    35
Fellow, Associate, and Affiliate Initiation Fee (New Members Only)	$  100
Seniors, Inactive, and Honorary Members Subscription Fee	$    45