2019 Annual Associate Membership Application
Please provide the following information about your institution:
Organization Name *
Your answer
Mailing Address *
Your answer
City, State, Zip *
Your answer
Telephone Number *
Your answer
Organization's Web Address *
Your answer
Please list the names, titles, and e-mail addresses for the individuals of your organization who will be MASFAA Associate members. *
Your answer
Amount Due - $80 per associate member *
Submit appropriate payment amount by March 1, 2019. Please confirm with your A/P department that they have the correct person and school name on the check. We can provide a W4 to update this information, if needed *
If you need to print this form to submit a check request, please print before submitting it. Google Forms does not generate a submission page after you submit. *
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