Application for Portland Section Affiliate Membership

a Portland Section Affiliate:
Is welcome at all local meetings and special events; receives notices for all Section activities; supports the Local Section activities by paying dues; may neither vote for nor hold an elective position but may participate in committees or activities.

Instructions: COMPLETE this ONLINE FORM and PRINT THE FORM BEFORE YOU PRESS THE SUBMIT BUTTON AT THE BOTTOM! Mail the form with your check (payable to Portland Section ACS) for $15 to:
Martha GK Dibblee, Secretary
Portland Section American Chemical Society
7201 SE 34th Avenue
Portland OR 97202
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I hereby apply for Local Section Affiliation:

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    PRINT THIS COMPLETED FORM BEFORE CLICKING ON THE SUBMIT BUTTON BELOW! Mail the form with your check. Thank you.

    PORTLAND SECTION USE ONLY Received by __________________________________________________ Date_____________________ Amount $____________________