Membership Application

First Name

Last Name

Phone

Email Address

Address Line 1

City

State

Zip/Postal Code

Which level of membership are you interested in? *

Industry Professional - $100 annuallyAcademic - $35 annually

Please indicate your key areas of interest. Check all that apply.

Professional DevelopmentLeadershipMentoringNetworking

What areas do you think you can make the biggest impact? Check all that apply.

Membership RecruitmentMentoring and/or sponsoring academic membersMarketingSpeaking or presenting at annual conventionIndustry Diversity, Equity, and InclusionWriting/EditingAwards review and programmingInnovationHuman resourcesSTEM Education ActivitiesOther

Describe any industry involvement you'd like to share with us.Please use the space below to provide any industry involvement you have had in your current or previous professional affiliations that you would like to share with us.

Complete the following for the Industry Professional Membership

Complete the following for the Academic Membership

Upon clicking "Submit" you will be redirected to a payment page.

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