Individual Membership Form

Individual Membership Form
e.g.undergraduate or graduate student
NOTE: Preferred method of communication is via email; announcements and notifications about upcoming events are sent via email.
Preferred Mailing Address: You can provide EITHER your home address OR your official institutional/ business mailing address. For the latter please include the name of the institution and department or division and the official mailing address (which for many institutions may be a departmental PO Box or Mail Stop Code rather than a street address).
 
NOTE: Print versions of journal and newsletter will be mailed to the preferred mailing address.
City
State/Province
Zip/Postal

Primary Phone

Secondary Phone

Annual Individual Membership Dues: (VAS Tax Identification Number is 54-6038285)
NOTE: Membership dues payments are based on calendar year – January 1 through December 31. Partial year memberships are not available.
(select ONE)
(check ALL applicable)
Sending