AFSAD MEMBERSHIP FORM

Your Contact Information Name:______________________________________ Campus Address:___________________________________ E-mail Address:______________________________________ Campus Phone:________________________ Method of Payment: [__] A. Half Payment (2 payments)    $15.00         B. Year Payment                        $30.00 [__] Check [__] Cash [__] Payment Enclosede Signature:_________________________ Date: __________

MAKE PAYMENTS TO:

Deborah Jones, Treasurer
Moot Hall Room 135A: Ext. 5713

CHECKS PAYABLE TO: AFSAD

TERM OF MEMBERSHIP
OCTOBER 1-SEPTEMBER 30TH

DUE ON OR BEFORE THE 1ST
SPRING MEETING!