Society of Adventist Communicators Membership Application
 
 
 
  Individual Membership — The annual dues are $25
 
  Institutional Membership — The annual dues are $50
    Includes up to three employees.
    Employee Name 1:
    Employee Name 2:
    Employee Name 3:
 
    Additional Employees — The annual dues are $10 per person
  Employee Name 4:
  Employee Name 5:
  Employee Name 6:
 
  Student Membership — The annual dues are $10
 
 
  Please fill out the required information
 
  First Name: *
  Last Name: *
  Billing Address: *
  City: *
  State/Prov:
* ZIP/PC:   
*
  Email: *
  Website:  
  Work Phone: *
  Cell Phone: *
  Job Title:  
  If a student,
where do you attend?:		  
  Employer:  
  Special Interest:  
  Password: *
  Confirm Password: *
   

 * Required