Iowa PAS 2017 Membership Form
The 2017 State Membership Dues will be calculated the same as previous years. The dues structure has the major advantage of allowing all students within a college's agriculture/agribusiness or natural resource program to get involved and participate without concern if the student is a PAS member or not.

DUE DATE: Tuesday, January 31, 2017
After you have submitted this form online, please submit a check to the address below:
Make Checks Payable to: IOWA PAS

Iowa PAS
Dwayne Faidley
Iowa PAS Treasurer
DMACC
1055 SW Prairie Trail Parkway
Ankeny, IA 50023

Name of Institution *
Your answer
Address *
Your answer
Advisor (Contact for Correspondence) *
Your answer
Office Phone Number *
Your answer
Advisor Cell Phone Number
In case of emergencies during Fall or Spring Conference
Your answer
E-Mail Address *
Your answer
Ag Program Enrollment on October 1, 2016 *
Your answer
Student Membership Dues *
Please check the box corresponding with your membership. This amount should be based on your total program enrollment listed above.
Membership Roster *
Type or Copy & Paste Student Members as of the membership due date. Please remember to include any graduates or former students wishing to maintain membership in 2016.
Your answer
Is an invoice required before your school can submit membership dues? *
By clicking yes, an invoice will be sent to you directly within 72 hours.
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