ATFE Membership Information Form
Please complete this form to help ATFE maintain accurate membership records.
For which year does this membership application and dues payment apply? *
Do you anticipate paying membership dues for this cycle via: *
For what membership status are you paying dues this year? *
Institutional Affiliation
Please provide institutional membership information here. In the next section, you will have an opportunity to provide membership information
What is your institutional affiliation?
Your answer
What is the mailing address of your institution?
Your answer
My institution is in:
Membership Information
Please provide name and contact information for either (A) the individual who has applied for individual membership status; or (B) all of the faculty and staff who belong to an institutional membership.
Individual Member 1
Member 1 name:
Your answer
Member 1 email address:
Your answer
Member 1 phone number:
Your answer
Member 1 mailing address (if different from institutional address):
Your answer
Individual Member 2
Member 2 name:
Your answer
Member 2 email address:
Your answer
Member 2 phone number:
Your answer
Member 2 mailing address (if different from institutional address):
Your answer
Individual Member 3
Member 3 name:
Your answer
Member 3 email address:
Your answer
Member 3 phone number:
Your answer
Member 3 mailing address (if different from institutional address):
Your answer
Individual Member 4
Member 4 name:
Your answer
Member 4 email address:
Your answer
Member 4 phone number:
Your answer
Member 4 mailing address (if different from institutional address):
Your answer
Emeritus/a Membership Information
Emeritus/a name:
Your answer
Emeritus/a email address:
Your answer
Emeritus/a phone number:
Your answer
Emeritus/a mailing address:
Your answer
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