Membership Application

MASEA Members-only area

Thank you for your interest in joining MASEA! Please complete the application below and click on the "Send Application" button. If you have any questions, please e-mail mmcorne@ilstu.edu

Name:

Title

Department

Institution/Organization

Address

City

State

Zip

Phone

Fax

E-mail

Referred by:
Name:
School:

All MASEA memberships run from July 1st - June 30th. Please indicate your membership type by checking the box below:

Individual membership = $50.00

Institution membership (3 members or more) = $125.00

After completing this form please click on the "Send Application" button. Once your application has been processed, you will receive an invoice via e-mail containing instructions on how to submit payment.

If you have any problems with this form, please e-mail mmcorne@ilstu.edu.

Note: You only need to click the button once.

 
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