If you are an ASA member, print this form and complete it.
Return it with a check for $5.50 (made payable to the ASA) to:
American Statistical Association
Department 79081
Baltimore, MD 21278-0081 USA
ASA Membership#__________________________________________________Name ____________________________________________________________Title/Position __________________________________________________Address___________________________________________________________________________________________________________________________City_____________________________________________________________State/Country ___________________________________________________Zip+4____________________________________________________________Telephone________________________________________________________Fax______________________________________________________________E-mail___________________________________________________________