Educator/Practitioner Membership Application/Renewal Form

Instructions For most efficient and expedient processing, please fill in the online membership and payment form below.
If you rather download and mail application click here for a printable PDF.

Position / Title *
Company / University *
Mailing Address *
Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeCountry
Office Phone
Alternate Phone
Email *
Secondary Email
Membership Type *
Professional $80.00 / yrRetired $45.00 / yrAcademic $55.00 / yrAssociate $40 (For first year after graduation)
** Dues are for one year from date payment is received

** Membership benefits do not start until application is received and processed.
Submission Information When you select the Submit button, you will be transferred to PayPal where you will be able to pay with your PayPal account or pay using a Visa, MasterCard or Discover card (this option is below the PayPal login).