D4 (Class of 2020) ASDA Application for 2019-2020
Please fill out the information below.

Total Amount: $100
[Dues breakdown: $88 to National ASDA, $12 to our LECOM ASDA Chapter!]

*VENMO (@asdalecom) is the accepted form of payment.

If you have any questions, please contact asdalecom@gmail.com.

NOTE: You can join at any time but in order to maximize your membership we suggest you join ASAP!
First Name *
Your answer
Last Name *
Your answer
Gender *
Phone Number (XXX)XXX-XXXX *
Your answer
LECOM Email Address *
Your answer
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