CACS Membership Registration Form

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Please pay dues online through PayPal first. Use the Payment Transaction ID to register. Start filling this form by clicking the "open in a new tab" button on upper right corner of this form. Thanks.

Email *

I hereby apply for membership to the CACS as a: *

Regular Member ($20/year)

Student ($10/year)

Life Member ($150 in one payment)

Please choose one Payment Method. If you choose PayPal/Zelle/Venmo, please leave your name in the notes.

1. PayPal link: https://www.paypal.com/paypalme/cacshq 2. Zelle account name: cacshq.org@gmail.com

3. Venmo link: https://account.venmo.com/u/cacshq

4. Check payable to “Chinese American Chemical Society”

5. Cash

PayPal

Zelle

Venmo

Check

Cash

Other:

Full Name: *

Organization: *

Local Chapter Membership (Select one and you will be automatically enrolled) *

East Chapter - covers New Jersey, New York, Connecticut, Pennsylvania and Delaware

Great Lakes Chapter - covers Illinois, Indiana, Iowa, Minnesota, Michigan, Ohio and Wisconsin

South-West Chapter - covers Texas (main), Arizona, California, Colorado, Nevada, New Mexico, Utah and Wyoming

Northern California Chapter

National Student Committee

None of above

Required

Field/Specialty: (Optional)

Highest Degree Earned: (Optional)

Phone #: (Optional)

Please enter your Chinese name here (optional)

A copy of your responses will be emailed to the address you provided.

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