AASSA Associate Membership Application

Thank you for your interest in becoming an Associate Member of AASSA. We look forward to working together and thank you for your support of our organization and our region.

Instructions:

Please complete the form below and Submit.

Upon receipt of your application, we will invoice you for the annual membership fee which covers membership for the academic year from July 1 through June 30.

INFORMATION ABOUT YOUR ORGANIZATION

Name of Organization:*

Name of Representative:

Prefix
First*
Middle
Last*
Suffix

Mailing Address:

Address 1*
Address 2
Address 3
City*
State*
Region
Zip Code* (ex. 06108 or 06108-0809)
Country

Phone
Ext

Email Address:*

Organization's Website:*

If you have any questions regarding membership, please do not hesitate to contact the AASSA office.

Thank you again for joining AASSA.

Please send a confirmation email to the address below: