Join AVAPL As A Trainee/Student Affiliate

To apply for training affiliate membership in AVAPL, please complete the following information (all fields are required except for those in red italics) and click the "Submit" button to go to the payment page. Training affiliate members pay reduced dues of $20. For an explanation of the levels of membership, please click here. Thanks for your interest in AVAPL!

First Name:  
Last Name:  
Degree:  
Job Title:  
University:  
Street Address:  
Address (cont.):  
City:  
State:  
ZIP Code:  
Work Phone:  
FAX:  
E-mail Address:  
Membership Type:  

 

If you want to pay for your membership by mail, please print out this page and mail it along with your check, made payable to AVAPL. For the address to send your application and check, please e-mail Ann Landes, Treasurer, at trea...@avapl.org (In order to thwart spammers, clicking on the above e-mail links requires you to respond to a "challenge" before the e-mail address is revealed. You need to click on the underlined ellipses [...] to activate the link.)

If you would like to pay by credit card, click the "Submit" button below to submit your application electronically and to go to an internet site where you can enter your credit card information. Click "Reset" to clear the above information and start over.