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CACS Membership Registration Form
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.
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Email
*
Your email
I hereby apply for membership to the CACS as a:
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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
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PayPal
Zelle
Venmo
Check
Cash
Other:
Full Name:
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Your answer
Organization:
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Your answer
Local Chapter Membership (Select one and you will be automatically enrolled)
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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)
Your answer
Highest Degree Earned: (Optional)
Your answer
Phone #: (Optional)
Your answer
Please enter your Chinese name here (optional)
Your answer
A copy of your responses will be emailed to the address you provided.
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