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Member Registration
 
This form is intended to be used for those that would like to register without registering to attend a meeting. If you want to become a member by attending our conference, please use the registration form found in the current meeting page.
 
Registrant Information
 
First:
Last:
Email:
Rank:
Address:
Address (2):
Address (3):
City:
State:
Zip/Postal Code:
Phone:
School/Company:
National ASM Member?
National ASM Member #
Membership Fees
Membership Dues:
Select all that apply
Volunteer
Please contact me about becoming a corporate sponsor.
Please contact me about serving on the MI-ASM Board.
I would like information about serving as a volunteer for MI Branch of ASM.
Special Needs/Comments?

 
Please make your check payable to MI-ASM and send to the following address with a printed copy of this form.
 

Laura Harris
Davenport University
200 S. Grand Avenue
Lansing, MI 48933

 
*Postdoctoral fellows are considered to be students.
 
Questions or suggestions concerning website, contact laura.harris@davenport.edu
Last updated: December 28, 2018