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MEMBERSHIP FORM
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Email
*
Your email
NAME
*
Your answer
INSTITUTIONAL AFFILIATION (if applicable)
Your answer
CAREER STATUS
*
Graduate student / Postdoc
University Professor
Teacher / Course lecturer
Other employed professional
Community worker
Artist
Other:
ANNUAL MEMBERSHIP FEES
*
Employed fulltime ($150-$200)
Medium income/ contract work ($100-$150)
Retired/ part-time/ low income ($50-$80)
Student/ Postdoc ($50)
Request to waive membership fees ($0)
In addition to my membership fees, I am donating $_________ to support the participation of a member with low-income
Your answer
Please identify any particular ways in which you would like to support or contribute to the functioning and work of the association within the next year
Your answer
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