Application Type: New Member Application Renewal Application Student Application

First Name:

Middle Initial:

Last Name:

Home Address:

Home City:

Home State:

Home Zip Code:

Home Phone:

Home Email Address:

List in Directory?: Yes No

Mail Newsletter to: Home Work

Profession:

Company:

Work Address:

City:

State:

Zip Code:

Work Phone :

List in Directory?: Yes No Both Neither

Fax:

Work Email:

Please tell us a little about yourself so we can introduce you to our membership:

I heard about AWC from: Friend AWC Member Trade Fair Article Ad Web Page

Please list specific source:

Membership Dues

Dues include National and local chapter membership and cover the period July 1st through June 30th.

New Membership - Remit dues using the following schedule:
Note: The membership year is July 1 - June 30. All memberships at the below prices expire June 30. AWC/PS is a non-profit US 501(c)(6) corporation, Federal ID 91-1202821

$60 Renewing Membership
Renewing members dues are due and payable July 1. Anyone not remitting dues by the first meeting in September will be considered a non-member. Non-members are not included in the directory or entitled to member dinner prices. A $15 NON-MEMBER FEE is charged to attend the program only.

$25 Student Membership
A full time student equals 12 credit hours toward an undergraduate degree and 6 credit hours toward a graduate degree, in any field. To qualify for the student rate provide a copy of your current Student I.D. card, or fill out the following information.

I certify that the named person is a full time student at:

Institution:

Department:

Name:

Title:

I agree to comply with the requirements, bylaws and regulations adopted by the Association.

Signature:

Date:

Payment Method: Money Order Cash Check Credit Card

The Directory is published and distributed to members each fall. Your listing is a brief resume, or a calling card to colleagues. Please provide the most recent information for your directory listing.

Check up to 6 of the following. If a consultant, also check box.