CSA MEMBERSHIP APPLICATION

Click here to download the application form in pdf format
Click here to download the application form in doc format

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

       Dr. Bing Huang, CSA Treasurer
       P. O. Box 3416, Cypress, CA 90630, USA

       (Please check): New  Or  Renewal

       Type of membership:

       (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