NYC Metro Chapter of the American Statistical Association
Associate Membership Application Form
* Required Field
First Name*
Middle Initial
Last Name*
Organization/Affiliation*
Email*
Confirm Email
Mailing Address*
City*
State*
Zip Code*
Phone Number (with area code)
Which are you applying for?*
New Membership
Renewal Membership
Type of Membership*
Regular Associate Member $8.00
Student Chapter Associate $2.00
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