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Family Science Association Membership Form 2011

Please complete:

NAME

JOB TITLE
INSTITUTION
ADDRESS
PREFERRED MAILING ADDRESS,
if different from above

OFFICE PHONE

HOME PHONE

OFFICE FAX

HOME FAX

EMAIL

CURRENT PROFESSIONAL
INTERESTS AND SPECIALTIES:

USERNAME

PASSWORD

(After you click on “submit,” you will be taken to the payment page on which is a link for using PAYPAL so you can pay directly online). If you pay by mailing a check, click submit, you can then close the PAYPAL window as you will not need it.
PLEASE USE PAYPAL OR SEND A CHECK FOR ANNUAL DUES. DUES ARE $50.00*. If paying with a check, make check out to Family Science Association & SEND CHECK TO:

Scott S. Hall
Treasurer, Family Science Association
AT 150
Ball State University
Muncie, IN 47303


*$35 for students, $65 for international members
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