AGLSP Individual Membership Application

Individual Membership Application

Use the form below to apply for an Individual Membership. The annual membership fee is $40.

NOTE: Applying does not guarantee acceptance into the association. Your application will be complete once approved and we have received membership dues.

Name:

Prefix (optional)

First Name

Initial (optional)

Last Name

Title:

Institution:

Email:

Address:

Address Line 1

Address Line 2

City

State

ZIP Code

Country

Phone number:

Briefly describe your interest in Individual Membership in the AGLSP:

Please let us know how you would like to pay the Annual Membership Fee once your application is approved:

Credit card Check

You will receive an invoice from PayPal within 48 hours. There is no charge for this service and you do not have to have a PayPal account.