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CSA MEMBERSHIP APPLICATION

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