Application 申請入會

Please fill the form below and then mail it with check to:

Prof. Kwan Ming Chan, CSA Treasurer
P. O. Box 1953, Huntington Beach, CA 92647, USA

 

Please check: New Or Renewal

Type of membership (The membership cycle is from Sept. 1 to Aug. 31):

(Please check): Regular ($25)       Lifetime ($200)     Associate ($10)      

1. Name (English): ___________

2. Chinese  Name: ___________

3. Affiliation and Title (University/organization)

______________________________________________________________________

4. Academic qualification, including year of degree awarded and name of universities: _____________________________________________________________________

Year of Ph.D., or equivalent  earned: _________________________________________

5. Office Address: _______________________________________________________

6. Email: __________________ Website: _____________________________

7. Phone:  ______________________ Fax: ____________________________

8. Home Address (optional) :________________________________________

City and Zip: _______________________________

9. Past Employment (optional): Year: ________   Job Title: _____________________________________________________________

Institution: __________________     Address: _________ ____________________________________

10. I am interested to get involved in: (Please check as many as apply)

- Annual assembly and spring gathering                    - Social gatherings, open house

- Forums, symposium, seminars                               - China tour (conference, lectures, visit)

- Publications                                                          - Webmaster

- Social science committee                                      - Science & Engineering committee

- Outreach activities                                                - Fundraising