Association for Applied and Clinical Sociology

You may renew or join on-line by clicking here.    If you wish to renew or join via land mail the application form lies below.  Please complete and then send us the printed application form.

____New Application ____Renewal

• Membership in AACS is from January 1 to December 31 2010.
• Payment in December, however, counts toward the next year.
• On-time payment ensures that you will receive your journal (Applied Social Science) without delay and have full voting rights.

Name:_______________________________________________________
First ____________________ MI. ____ Last _________________________
Home Address:__________________________________________________
_____________________________________________________________
City:___________________________________
State:____________ Zip code _____________
Country __________________________________________________________
Telephone: __________________ Cell phone: ____________________
FAX: ___________________
Institution/Organization/Company Name:___________________________________________
Address: ___________________________________________________________________
City:___________________________________
State:____________ Zip code _____________
Country __________________________________________________________
Telephone: __________________
FAX: ___________________

Which address do you prefer for AACS communications: ________Home _____ Institutional

E-mail Address _____________________________________________________
All AACS members are requested to provide an e-mail address.

AACS members may join the AACS online discussion list.
Would you care to subscribe to the AACS discussion list? ___Yes ___No

Certifications:
CSP: ___Yes ___No
CCS: ___Yes ___No
Certification Renewal Fee: $20

Please note other certifications and licenses:
1. ____________________________________________________
2. ____________________________________________________
3. ____________________________________________________

Professional Specialties: 1._________________________________ 2.______________________________________________________ 3.______________________________________________________

CALCULATE DUES AND OTHER PAYMENTS
Please check which membership is most appropriate for you:
(All membership categories include the Journal and our newsletter.)
______Regular Member $90
______Student Member $40
______Organizational Member $210 (Includes full page ad in the Annual Program)
______Retired Member $50
______International Regular Member $110
______International Student Member $50
___________Donation to AACS (to support students, awards, etc.)
___________ Certification Fee

$____________TOTAL

Make check payable to: Association for Applied and Clinical Sociology.
(Please use memo line on your check to indicate membership level.)

Please send your completed application and check to:

Fonda Martin
Executive Office
712 Pray-Harrold
Department of Sociology
Eastern Michigan University, Ypsilanti MI 48197

Office 734-487-0012
Fax 734-487-7010