2015-2016 WCC Membership Form

Please complete all the required information and submit your membership dues via the PayPal link available on our website (www.pghWCC.org).

First Name

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Last Name

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Street Address 1

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Street Address 2

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City

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State

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Zip Code

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Email Address

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Phone

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Professional Affiliation

Please enter the name of where you work or attend school currently

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Position

What is your position with your company or at what stage in your education are you as a student

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Please select type of membership

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I am currently a member of the American Chemical Society

*membership in the ACS is not required for WCC membership

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