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Renew Membership: Snake River Chapter dues are $10 per year. You may pay your chapter dues along with your ASA dues, or you may pay them directly to the chapter treasurer.

 


 

Membership Application Form

 

Name ( last, first, middle initial): ______________________________________

Organization: _____________________________________________________

Mailing address: ___________________________________________________

                        ___________________________________________________

                        ____________________________________________________

                        ____________________________________________________

                        ____________________________________________________ 
 

Phone: _____________________________________________________

Fax: _____________________________________________________

E-mail: _____________________________________________________ 
 

Maybe we post your name and E-mail on our Homepage under members?  YES   NO 
 

Please mail completed form with payment by check to our secretary:

Cindy Gentillon

Human Factors and I&C Department

Idaho National Laboratory

P. O. Box 1625, MS 3605

Idaho Falls, ID 83415-3605