ACSE Application Form

Name _______________________

Address ______________________________________________________________

Affiliation ___________________________

Phone Number ___________________________

Email ________________________

Highest Degree Earned _______________________

The annual membership fee for regular member is $15 per person, and $20 per married couple. The annual membership fee for student member is $8, and $10 per married couple.

Make check payable to ACSE, Phoenix and send it to:

Association of Chinese Scientists and Engineers, Phoenix Chapter, U. S. A.

P.O. Box 8144 Chandler, AZ 85246-8144