ASDA Membership Application for 2020-2021
Please fill out the information below. You may provide cash payment to one of the following ASDA Executive Council Members:
Amelia Crawford (D3), Kasim Naqvi(D3), Josh Graham(D2), Victoria Carroll(D2

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

* Cash, VENMO (@asdalecom) are accepted forms of payment.

If you have any questions, please contact

NOTE: You can join at any time but in order to maximize your membership we suggest you join ASAP!
First Name *
Last Name *
LECOM Email Address *
Class Year *
Gender *
Phone Number (XXX)XXX-XXXX *
Do you have the same mailing address as last year? *
Were you a LECOM ASDA member last year? *
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