Become a Portland Section Affiliate
To become a Portland Local Section Affiliate complete the form below.
A Portland Local Section Affiliate:
Is welcome at all Portland Section ACS meetings, activities and events
Receives all Section notices
May pay voluntary dues of $15
May neither vote for nor hold an elective position
May participate in, but not chair, committees

Dues are voluntary. If you choose pay dues, there are two options.
1. You may print this form and mail a copy of the printed form (which serves as an invoice) with your check for $15 (payable to PORTLAND SECTION ACS) to:
Portland Section American Chemical Society
Attn: Portland Section Treasurer
PO Box 1741
Portland OR 97207-1741
2. You may pay by credit card at http://bit.ly/SQUOSSF (scroll to lower half of page).

3. We do not share email addresses with anyone.

4. To ensure receipt of email notices (from ACS MagnetMail) include "martha@acsportland.org" in your list of email addresses.

4. ACS Affiliate cards are available at a Section meeting.

5. Entries to this form are automatically sent to Portland Section ACS.
______________________________________________________________

I hereby apply for PORTLAND LOCAL SECTION Affiliate Membership:

FIRST NAME
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LAST NAME and SUFFIX if any
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PRIMARY COMPANY NAME
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PRIMARY DEP'T NAME & MAIL STOP or APT #
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PRIMARY MAILING ADDRESS
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PRIMARY CITY
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PRIMARY STATE
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PRIMARY ZIPCODE
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PREFERRED EMAIL ADDRESS
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PREFERRED PHONE NUMBER
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EDUCATION & MAJOR
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FOR TEACHERS: GRADE LEVEL
VOLUNTARY DUES
Dues are voluntary. If you choose to pay, DUES are $15. You may pay by credit card online at http://bit.ly/SQUOSSF or by check. if you pay online send an email to bcarlsen@reed.edu. If you submit a check to the Section, print two (2) copies of this form and keep one copy as your record of payment. You also may use a credit card to pay dues at a Section meeting.
AMOUNT ENCLOSED
Print and enclose a copy of this form if you submit a check for voluntary dues payment. Mail your payment to Treasurer, ACS Portland Section, PO BOX 1741, PORTLAND OR 97207-1741.
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CHECK NUMBER
Write your check number below.
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Pay online after you click SUBMIT below.
Portland Section Use Only
Date received and initials.
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